Soccer Camp Registration Form

Please select the weeks of camp you would like your child to attend.

__ World Cup and Goalkeeping: June 14 – 18: Overall skills training and games__

__ Pele Foot Skills: June 21—25:Improve foot skill, dribbling, first touch, and  pulling move

__ Goal Scoring Glory and Goalkeeping: June 28 – July 2: Shooting and defending shot

__ Air Balls: July 12– 16: 50/50 balls, taking the ball out of the air, headers, volleys

__ Dynamic Defending and Goalkeeping: July 19– 23: Defending

__Team Player: July 26– 30: Passing, making runs, team shape, team functions

__World Cup and Goalkeeping: August 2-6: Overall skills training and games

Please fill out completely-

Name 1: __________________________________________ Date of Birth: _________________ Age: _______

Name 2: __________________________________________ Date of Birth: _________________ Age: _______

Name 3: ______________________________­­­____________ Date of Birth: _________________ Age: _______

Address: __________________________________________________________________________________

City: ________________________________________________________ State: ______ Zip: _____________

Parent’s/Guardian’s Name: ___________________________________________________________________

Email: __________________________________________ Cell Phone: ________________________________

Emergency Contact:_________________________________________________________________________

Please read the following information carefully. No child will be admitted into Soccer Skills Camp unless either a parent or legal guardian signs this form. By signing this form, you are releasing all claims for injuries that the participant may sustain.

I agree to assume full risk and to waive and release all claims I and/or the participant may have against All star sports arena. This release also includes ASSA agents, servants and employees from any such claims resulting from injury, responsible for all personal medical insurance and that the participant’s family must cover all medical cost incurred. I also understand that every precaution is taken to protect the safety of each participant. I agree to emergency treatment by a physician or hospital in the event that the emergency contact listed cannot be reached.

Parent (or legal guardian) signature: _______________________________________ Date:___________

Turn in all forms to the All Star Sports Arena or email to kendall.soccer@yahoo.com