UK International Soccer Community Day Camp Application
Complete one
application per player. Make check(s) payable to UK
International.
Mail with full payment to UK International Soccer Camps, Inc. P.O.
Box 1838, Redlands, CA 92373
or fax to: (909) 793-7310. Call office (888) UK SOCCA, or local
coordinator for further information.
Players
Name:_____________________ Age:_____ Date of
Birth:_________________
Parent/Guardian
Name:____________________ Player's Sex: M F (circle)
Address:_______________________________________________________________
City:___________________________ State:____________
Zip:___________________
Phone: Home (___)
_________________ Work (___) ___________________________
E-mail Address:
_________________________________________________________
Name of
Organization/Team:
_______________________________________________
Dates of Camp:
________ Location: _________________________________________
Half Day
Full Day
Time of
Session:___________________________________
Check appropriate boxes:Fun in the Sun
(4-6yrs.)Skills'n'Thrills (7-10yrs.)
Compete With your Feet (11yrs.+) Team (If available)
GK (If
available)
Strikers (If available)
Camp Cost: $
________ Family Discount ($5 for 2nd, 3rd, etc. sibling)
Shirt Size: YM(10-12)YL(14-16)AS(34-36)AM(38-40) AL(42-44) AXL(46-48)
GK Clinic $25 (optional)
Strikers Clinic $25 (optional)
Ball $15 (optional)
Water Bottle $5 (optional)
Shinguard $10 (optional)
XXS (4-6 yrs)
XS (7-8 yrs) S (9-12 yrs) M (13-16 yrs)
Total Cost $
_____ Payment:
$________ Cash Check CK#_____ Credit
Card
Credit Card (check one) Visa
MasterCard Discover
#_________________________________________ Credit Card Exp. Date
(mo/yr): _______
Signature: ______________________
YES, I want more information on: Hosting a coach
Residential
programsUK
Camp in the UK
How did you hear about us?
_________________________________________
I Certify that my child
enrolled above is in excellent health and may participate in strenuous physical
activities including soccer. I agree to defend and hold UK International
Soccer Camps, its servants, agents, and/or employees and contractors harmless
from any and all claims for injuries sustained by my child during his or
her participation in the camp. Permission is hereby granted to UK International
Soccer Camps, to use pictures and any video footage of the campers in any
promotional materials without compensation, plus all mailing and emailing
addressess for any communication and / or programs. Permission is granted
for my child to receive emergency medical treatment, if needed, and I certify
that there are no limits to my child's participation except as stated in
writing and included with this application. Refunds can be given at the
discretion of UK International depending on the nature of the situation.
Children who leave during the program due to injury or illness will receive
a pro rata refund. A $25 handling fee will be required on any refund, no
refund will be given for cancellation within 14 days of the camp start date.
Children are enrolled on a fist come first served basis. We cannot guarantee
enrollment any later than 5 days prior to camp. Should inclement weather
or acts of God affect the program, any lost hours will be made up later
in the camp week. If this is not possible, refunds will not be issued.
Signature of
Parent/Guardian......................................................................
Date.................................