FEARLESS SOCCER CAMPS TEAM PLAYER

REGISTRATION FORM 2010

* = required field

First Name Camper *

Last Name Camper *

Date Of Birth *
 

Age At Time Of Camp *

Gender *

Grade Level *

Shirt Size *

Highest Level Played *

Have You Attended Fearless Camps Before? *

Please List Past Fearless Camps You have attended

     
     
     
     

Select TEAM Camp You Wish to Attend *

Last Name Of Primary Guardian *

First Name Of Primary Guardian *

Email Address(Preferred) *

Email Address(Alternate )

Day Phone Prefered (No Dashes Or Spaces please include area code) *

Emergency /Alternate Phone *

Emergency Contact Name *

Street Or P.O. Box# Mailing Address (GUARDIANS) *

City *

State *

Zip Code *

Comments Special Conditions,Any Medical Restrictions

I Agree & Accept Fearless Soccer’ s Release Of Liability Form Posted On Site *

Name Of Team You Will Be Attending Fearless Soccer Camp With

Choose type of TEAM CAMP and date you wish to attend Lake Tahoe Camps *

     
     
   
   

Coach/Organizers First Name

Coach/Organizers Last Name

Coach/Organizers EMAIL ADDRESS

Coach/Organizers DAY PHONE NUMBER

Please Add The After Hours Adventure Package On to Your Camp For additional($125)

Please Add A Fearless Camp Sweat Shirt To My Camp Package ($25)

Sweat Shirt Size for

Sweat Shirt Color

Please Add a Multi Touch Ball For ($25)

Please Add Fearless Soccer Camp Picture CD For($25)