Application

Child's Information

Name:

Age:

Any medical conditions?:

Parent's Information

Name: (required)

Email: (required)

Phone:

Alternate Phone:

Address:

Camp Information

Please select one of the following:

I am interested in the UKSA Camps I am interested in the SSE Camps I am interested in the NFFC Team Camps

Umbro Ball ($10.00, picked up on first day of camp):

By filling out this form, you agree to the following: I hereby authorize the staff of the UKSA Soccer Camp to act on my behalf and to the best of their ability in any emergency requiring medical attention. I also hereby waive and release the staff of the UKSA Soccer Camp from liability for injuries that occur at the camp. I also understand that the camp retains the right to use for public an/or advertising purposes, photos taken during the camp.

NO CASH REFUNDS - CREDIT ONLY