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Camp Registration

Please fill out and submit this form to register for a camp session with 24-7 UK Soccer Academy.
You will be able to pay by credit card or see other payment options after submitting this form.

* Indicates required fields.


  CAMP INFORMATION
*Camp Name
*Camp Dates (start - end) -
*Camp Days Mon Tues Wed Thur Fri Sat
*Camp Times (start - end) : - :


  PLAYER #1 INFORMATION
*First Name

*Last Name

*Date of Birth (mm/dd/yyyy)
*Age
*Sex
Male   Female
Medical Conditions (if any)


  PLAYER #2 INFORMATION
First Name

Last Name

Date of Birth (mm/dd/yyyy)
Age
Sex Male   Female
Medical Conditions (if any)


  PARENT/GUARDIAN INFORMATION

*First Name

*Last Name

*Home Phone (xxx-xxx-xxxx)
Cell Phone (xxx-xxx-xxxx)
*Address 1
Address 2
*City
*State
*Zip

  MEDICAL RELEASE WAIVER (covers child for all activities in 2012)
I have already signed a 2012 medical release waiver for my child.
I need a 2012 medical release waiver for my child.
      (A link to download the waiver will be provided after submitting this form.)


  COMMENTS
Please add any additional comments or suggestions.

Please check if you do not wish to receive any information about 24-7 UK Soccer Academy.


  YOUR INFORMATION

*Your Name

*Your E-Mail Address


Please Enter Security Code
  

24-7 UK Soccer Academy is open to players around the East Bay Area (California) including: Alameda, Castro Valley, Danville, Dublin, Fremont, Hayward, Livermore, Newark, Oakland, Piedmont, Pleasanton, San Leandro, San Lorenzo, San Ramon, and Union City.

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