Mid-Term Football Camp 2020

First Name *

Last Name *

Age *

Current School *

Email *

Phone *

no spaces or dashes (-)

Days attending *

select days child will be attending

Late Pickup

select days late pick-up will be needed (5:30-6:00pm)

Name and telephone number of emergency contact person *

Name(s) of additional person(s) authorized to collect your son/daughter at pickup time *

Does your child have any allergies/medical conditions? *

No

Yes (please specify here)Yes (please specify here)

Payment method *

Bank Transfer (preferred)

Cash

Liability Waiver and Medical Authorization

Covid-19 Waiver

Please check box *

I have read and agree to all terms above

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