Soccer Camp Registration Form
Please fill out your details to register for the camp on July 20 and 21.
Participant's Full Name
*
First Name
Last Name
Participant's Date of Birth
*
-
Month
-
Day
Year
Date
Parent/Guardian Name
*
First Name
Last Name
Parent/Guardian Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Emergency Contact Name
*
First Name
Last Name
Emergency Contact Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Please confirm which camp date(s) the participant will attend
*
July 20
July 21
Please list any medical conditions or allergies we should be aware of
How will you be paying the $45 for registration?
*
Please Select
cashapp - 903premierleague
venmo- premierleague903
Register
Should be Empty: