Clone of 2026 Camp Cup

2027 CAMP CUP

January 9-10th

Skate Safe America

182 Bethpage Sweet Hollow Road

Old Bethpage, NY 11804

Athlete Information

Player Name

First NameLast Name

Mom's Name

First NameLast Name

Mom's Email

Dad's Name

First NameLast Name

Dad's E-mail

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Cell Phone

Area CodePhone Number

Home Phone

Area CodePhone Number

E-mail

Division

Camp (8th Grade and Under)

Camp (11th Grade and Under)

Camp (Alumni)

Payment Method (Team Fee - $1,150 -- INDIVIDUAL FEE - $195)

USDTeam Fee

Credit Card

First Name

Last Name

Credit Card Number

Security Code

Expiration Month

Expiration Year

Billing Address

Street Address

Street Address Line 2

City

State / Province

Postal / Zip Code

Country

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