Player Information: *

First Name

Last Name

Date of Birth *

MM

DD

YYYY

Which Camp would you like to register for? *

Discounts Available: $50 OFF | Sibling Discount $50 OFF | Attending both Summer Camp Weeks

Summer Soccer Program

Elite Soccer Program ( Ages: 12 to 18 )

Baby Ballers Introduction ( Ages: 3 to 5 )

T Shirt Size *

Adult

Youth

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Name *

First Name

Last Name

Phone *

(###)

###

####

Water Fitness Waiver *

Assumption of Risk: I, the guardian, grant permission for my child (named above) to use the Boys and Girls Club Swimming Pool; I recognize and understand that using the Swimming Pool involves certain risks. Those risks include, but are not limited to, the risk of injury resulting from possible malfunction of the equipment used in the pool and injuries resulting from tripping or falling over obstacles in the pool area.)

YES

NO - I am not interested in Water Fitness