Elk Rapids Soccer Skills Camp

2014 CAMP REGISTRATION FORM

Name: _______________________________Birth date_________ Age_______ Male ___Female ___
Name: _______________________________Birth date_________ Age_______ Male ___Female ___
Name: _______________________________Birth date_________ Age_______ Male ___Female ___
Address____________________________________City____________________St______Zip________
H.Phone________________________Cell_______________E-mail______________________________
Please check session and time that you want. The camp will take only 14 players per week for the U10
session, 18 players per week for the U12 session and 22 players per week for the U14 session.
Sign up NOW to reserve a spot in one session or as many as you want.

Sessions: 8:30 - U10 (90 mins) 10:30 - U12 (120 mins) 1:00 - U14 (120 mins)
Circle date AND check time 8:30 am
July 7 July 10
July 21 July 24
Camp Class
U10
U12
U14

10:30 am 1:00 pm

Cost
$60/per player/per week - $55 each additional sibling
$80/per player/per week - $75 each additional sibling
$80/per player/per week - $75 each additional sibling

A non-refundable $20 deposit per player, per session OR full payment must accompany this form.
Balance due must be paid in full 1st day of session. Please make checks payable to Matt
VandeKerkhof and mail to 314 Ottawa Street, Elk Rapids, MI. 49629
RELEASE
I, the undersigned, individually and as parent(s) and guardian(s) of ____________________________ a
minor, ask that he/she be admitted to participate in this sport camp sponsored by Matt VandeKerkhof. In
consideration of such admission, I do hereby agree to release, discharge, and hold harmless Matt
VandeKerkhof, its officers, sponsors, employees of and from all causes, liabilities, damages, claims, or,
demands whatsoever on account of any injury or accident involving the said minor arising out of the
minors attendance at the soccer camp or in the course of competition and/or activities held in connection
with the camp.

Signature___________________________________________________
Photograph permission: I agree to let my minor childs picture be shown on the ERSSC website/brochure
Signature__________________________________________________
Do not forget, a water bottle, soccer ball and shin guards. Thursday is popsicle day! All camp sessions will
be held at the Kewadin soccer fields. Please direct any soccer questions to Matt at 231-649-4351 and any
registration questions to Sonya at 231-357-3081. See you at the field rain or shine! facebook.com/ERSSC