SPRING AND SUMMER 2009 APPLICATION
NATIONAL CAPITAL SOCCER ACADEMY
SOCCER CAMP
 


Name:
Address:
City:
State:
Zip:
 
E-mail address:
Home Phone:
Boy Girl Age:
Birthdate:
Grade in Sept '09:
School: Club:
 
Soccer Experience (# of seasons):
Positions Played:
Height: Weight
 
Father's Name:
Father's Work Telephone:
Mother's Name:
Mother's Work Telephone:
 

2009 Spring and Summer Soccer Training
8:00am early drop off - 5:00pm late pick up offered

 

2009 Summer Camps Located @: Jelleff Boys & Girls Club
  Tuition Fee Please Check Session if you will attend:
Session #1 June 8 – June 12, 2009 $260.00
Session #2 June 22 – June 26, 2009 $260.00
Session #3 August 3 – 7, 2009 $260.00
Session #4 August 10 – 14, 2009 $260.00
Session #5 August 17 – 21, 2009 $260.00
Session #6 August 24 – 28, 2009 $260.00
 

  

  
Check T-Shirt Size: Adult S M L XL Child S M L
 
Early Drop-off (8:30 am) & Late Pick-up (5:00pm) $40.00
(for the week)
 
Deposit $75.00 ($25.00 non-refundable) Yes No  
Check No:
Check Amt:
 
I have printed and filled out a copy of the
Medical Waiver/Insurance Policy form		 Yes