LITTLE CARDS SOCCER CAMP 2014

This camp is about learning fundamentals and individual skill break down as well as a time-honored tradition of fun! Camp coaches will be 2014 Corbett high school players in addition to the Corbett coaching staff. Invite your friends!

(Incoming K-6th graders)

August 11th-14th 9:00-11:00 am

$40.00 (includes t-shirt)

*Please arrive 15 minutes early on August 11th to register at the HS soccer field.

Player Name ___________________________ School _________________ Grade __ Age__

Address____________________________________________________________________

T-shirt (circle one) YS YM YL S M L Parent/Guardian __________________________

Phone (hm/cell)________________________ Email ________________________________

Emergency Contact & Phone # __________________________________________________

Allergies ___________________________________________________________________

Medications_________________________________________________________________

By signing below, I assume any risk of harm or injury which might occur to the above player due to their participation in this event. If the participant is a minor, I agree that the minor has my consent to participate in this event. I further provide my consent for Staff to seek emergency treatment for the minor if necessary. I agree to accept financial responsibility for the costs related to this emergency treatment. I authorize photos of above participant to be released to Corbett Soccer for their use.

Signature of Parent or Guardian: _______________________________ Date: ____________

*Pre-registration is appreciated but not required. Form can be mailed to:

Corbett Soccer PO Box 33558 Portland, OR 97292

Paid _____