SUMMER CAMP 2024

Parent/Guardian Name *

First Name

Last Name

Player Name *

First Name

Last Name

Player Date of Birth *

MM

DD

YYYY

Contact # *

(###)

###

####

Shirt Size *

Youth Extra Small

Youth Small

Youth Medium

Youth Large

Adult Small

Adult Medium

Adult Large

Week(s) Attending *

July 1-3 (3 days)

July 8-12

July 15-19

July 22-26

Waiver *

I, the parent/guardian by checking this box, I am verifying that my child is covered by medical insurance and that he/she has been checked by a physician and is physically able to participate in soccer activities. I also agree to release City Starz Soccer, its employees, officers, agents and hosting facilities from any liability, which may occur while my child is attending the camp.

I agree