| Seneca High School's Gold and Goal Soccer Camp For Boys and Girls July 21-25 9:00-1:30 at Seneca High School inTabernacle, New Jersey directed by Seneca Soccer Coaches Sam Maira and Ron Jensen Questions can be answered by calling 268-4600 ext, 6687, e-mail [email protected] for boys and 268-4600 ext. 6731 or 1-856-216-7494, e-mail [email protected] for girls. |
| Gold and Goal Soccer Camp Application Name_________________________M___F___ Entering Grade_____ E-Mail____________________________ Address_____________________________________________________________________________________ City______________________________________ Zip______________ Phone___________________________ Please circle ball and shirt size T-shirt (free if enrolled by July 11): Adult S M L XL Youth L Ball size, if purchased (add $10): 4 (ages 7-11) 5 (ages 12-up) ___ $135 after June 1, $120 before June 1 ___ Soccer ball, $10 ___ Total Enclosed $_________________ Complete below only if you are registering as a team Team Name: _____________________ Age Bracket: U-___ Coaches Name: ___________________ Please accept my registration for the Gold and Goal Soccer Camp, at Seneca High School. I understand that each registrant should bring his/her own sneakers, soccer shoes, shin guards, lunch and water bottle. I understand the camp and staff are not responsible for lost items. The camp will provide secondary insurance for each registrant. Primary coverage will be through each registrant's own insurance plan. As a parent/guardian of the registered child, I give my approval to her participation in the camp. In case of injury to my child, I waive all claims resulting from or in connection with the activities in which my child is a participant. I release, absolve, indemnify, and hold harmless the Gold and Goal Soccer Camp, its coaches, directors, trainers, Seneca High School, and its members, officers, organizers, sponsors, and the supervisors. X_______________________________________________________ Parent or Guardian Signature Please complete all information and mail with $135.00 or appropriate fee to Coach Sam Maira, 14 Meadowbrook Drive, Shamong, NJ 08088. Checks should be made out to Gold and Goal Soccer Camp. |