Don't miss out on the hardest working program on Long Island... "Train to Play, Play to Win"
Please Fill out and bring to registration table at first day of camp or clinic event. Thank You!
NAME OF PLAYER:_______________________________________________________________ ADDRESS:__________________________________CITY:_______________ZIP:____________ DATE OF BIRTH:____/_____/____AGE:_____ GENDER: Female____ Male____ Grade______ HOME PHONE:______________________________ MOBILE PHONE:____________________ E-MAIL ADDRESS: _______________________________________________________________ EMERGENCY CONTACT:_______________________________PHONE:__________________ PROGRAM FEE PAID:$___________________________ CHECK #________________________
Parent/Guardian: I certify that my child enrolled above is in good health and has my permission to participate in camp activities including soccer. I am aware of the risks associated with my son's/daughter's involvement in the camp and camp related activities. In the event of an emergency, I hereby give permission to ELS staff, camp director and physician selected by camp director to secure proper treatment for the camper. I will be fully responsible for all medical expenses incurred by my child while attending the prgram. I give permission to ELS to use my child's images in future advertising and Promotional materials.
Signature: _________________________________________________ (Parent/Guardian) Date: ____________________________ For any questions contactJaime/Gary at email@example.com or 516-369-7797
** Goalkeeper training is offered at every training site in conjunction with field players**