SUMMER CAMP 2025

Parent/Guardian Name *

First Name

Last Name

Player Name *

First Name

Last Name

Player Date of Birth *

MM

DD

YYYY

Contact # *

(###)

###

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Shirt Size *

Youth Extra Small

Youth Small

Youth Medium

Youth Large

Adult Small

Adult Medium

Adult Large

Week(s) Attending *

June 30 - July 3 (4 days)

July 7 - 11

July 14 - 18

July 21 - 25

July 28 - Aug 1

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