SC Blues Soccer Club, Presents our Thanksgiving Soccer Camp for players born in 2012 to 2004

Week: November 2oth-22nd
Camp will run, Monday thru Wednesday, 9am to 12pm. 
Cost: $100
Please complete our registration form
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Players Full Name *

 
Players Date of Birth (MM/DD/YEAR) *

 
Camp date you are signing up for


 
Which payment method will you be selecting



 
Mothers Name *

 
Please provide contact number for 

 
Fathers Name *

 
Please provide contact number for 

 
Home Address *

 
Please provide an emergency contact number:

 
What school does your daughter attend? *

 
Does your daughter have any allergies or medical conditions? *

 
Waiver and Release of liability

By accepting this form for my daughter's contact information, in order to induce The Southern California Blues Soccer Club to accept registration for our Soccer Camp and permit our (my) daughter or daughter's participation in the Club’s activities, I (we) the parent or guardian or (s) hereby authorize the Southern California Blues Soccer Club, or person acting in capacity of activity supervisor, coaches, players as Agents for the undersigned to consent to medical, surgical or dental examination, treatment, etc.  In case of emergency we hereby authorize treatment and/or care of our daughter at any hospital approved by the Agent hereby authorized.   Also this child does not have any disabilities, handicaps, present injuries or limitations, allergies, hemophilia, heart condition, history of respiratory illness or any other significant limiting medical condition that would preclude her active participation in the contact sport of soccer. I hereby waive and release The Southern California Blues Soccer Club; it's officials, agents, players, parents, coaches, and representatives, from any and all liability for any injuries, illness or death incurred while at this Soccer Camp.
     
Thank you for registering for our Blues Thanksgiving soccer camp. If you have any questions please email Robbie on robbie@scblues.com
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