Summer Camp Application
First Name:
Last Name:
Date of Birth: January February March April May June July August September October November December 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006
Age: 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
Parents Name(s):
Email Address:
Home Phone:
Cell Phone:
Address:
City:
State:
Zip:
Gender: Male Female
Position: Field Player Goalkeeper Both
T-Shirt Size: Youth Large Adult Small Adult Medium Adult Large Adult XLarge
Camp: July 12th to 16th Minnechaug High School Wilbraham, MA July 19th to 23rd Michael E. Smith Middle School South Hadley, MA July 26th to 30th Spec Pond Boston Rd. Wilbraham, MA August 2nd to 6th Spec Pond Boston Rd. Wilbraham, MA
Ages: 3-5 (Kids Club) 5-12 10-18(Only Advanced Week)
Prices: Kids Club 9:30-10:30 $85 Full Day 9am to 3pm $155 Half Day 9am to 12pm $125
Summer Camp Discount Form
This form needs to submitted with your Summer Camp application
Check each box for which your child participated. Discounts are marked next to each title..
Kid’s Club
(10% for each session)
Session
I II III IV
Training Center
($25 for each session)
I II III
Advanced Training Center
I
Vacation School
February Break April Break
Soccer City, Inc. is not responsible for articles lost or stolen. All players are required to have their own medical insurance. The facility will not be held liable for any injury sustained during the competition or instruction. I agree to follow the above regulations and all other rules governing the competition or instruction.
Signature: