_____Week 1 August 8-12 register by July 1 for ages 5-14 All day/full week cost: $225

_____Week 2 August 15-19 register by July 15 for ages 5-14 Cost: $225

_____Week 3 August 22-26 register by July 31 for ages 5-14 Cost: $225

*Morning session only Cost: $135
We offer team discounts for 7 or more from the same team. 9th team member enroll free or 7th team member enroll
with a 50% discount. Just do it... simply!

Reservation deadline: Applications are accepted on a first come/first served basis. Week 1 registration deadline
July 1, Week 2 registration deadline July 15, Week 3 registration deadline July 31.

Name: ________________________________________Phone_____________________________

Address:________________________________City/Zip: _________________________________

E-Mail _____________________________

Age: ______ DOB:________ Grade: ________ School: ___________________

Please note any medical condition:___________________________________

Insurance Company:______________________Policy # ____________________

Doctor's Name and #:_________________________________________________

Emergency Contact:___________________________________________________ 

I hereby authorize the staff at Simply Soccer Camps to act for me

according to their best judgment in any emergency requiring medical

attention and hereby waive and release the camp from any

injuries or illness while at camp. The camp staff has my permission to

seek any emergency treatment necessary for my child while in attendance at

the camp named above. 

Parent/Guardian Signature: _____________________________________Date:_________________

Kindly print this form and make check payable to Simply Soccer and send to:

Have fun, play hard!

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