NASC/English School of Soccer Camp
205 Rolling Hills Drive
Wexford PA 15090.

Enroll early to ensure your child's place. For questions call 724/940-7387.

Cost: All programs cost $90.00 except goalkeepers which costs $105.00.

Camper Name: __________________________  Birthdate: ________________

Address: ___________________________________________________________

Phone: ______________  Circle Preferred Session:  AM   PM
 

Camp Program (Circle One):  Nippers    Intermediate     Advanced    Goalkeeper
 

Ball Size: (Age on July 31, 2000)
    ___ Age 10 or Under (Size 3)

    ___ Age 12 or Under (Size 4)

    ___ Age 13 or Over (Size 5)
                            

Camp T-Shirt:    ___ YM  (10-12, if available)
                 ___ YL  (14-16)
                 ___ AS  (34-36)
                 ___ AM  (38-40)
                 ___ AL  (42-44)
                 ___ AXL (44-46)

Are you interested in hosting a coach? ________

I certify that my child enrolled above is in excellent health and may participate in strenuous physical activities, including soccer. I agree to hold the English School of Soccer, its servants, agents and/or employees and contractors harmless from any and all claims of injuries sustained by my child during his or her participation in the camp. Permission is hereby granted to the English School of Soccer Camp, to use pictures of campers in any promotional materials. Permission is granted for my child to receive emergency medical treatment, if needed, and I certify that there are no limitations to my child's participation except as stated in writing and included with this application.

Parent/Guardian: _______________________________      Date: ____________

Emergency Contact and Phone Number: _____________________________________