Elk Rapids Soccer Skills Camp

2013 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 for 1 WEEK only for the U14 session. Sign up NOW to reserve a spot in one session or as many as you want.

U10 is the 8:30 session (90 mins) - U12 is the 10:30 session (120 mins) U14 is 1 WEEK only!!! July 8 July 11 at 1 pm (120 mins) Please no incoming ELK Rapids school freshmen. Circle date AND check time 8:30 am 10:30 am 1:00 pm June 17 - June 20 X June 24 June 27 X July 8 July 11 July 15 July 18 X July 22 July 25 X Camp Class U10 U12 U14 July 8 July 11 Only 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!