College Bound Soccer Camp Registration

(*) denotes required information.
* Select camp option:
Overnight ($400) Day Camp ($350)

* First Name:
* Last Name:
* Address:
* City:
* State:
* Zip:
* Birthdate:
* Email:
* Position:
* Shirt Size:
S M L XL

* Name of Parents:
* Emergency Contact:
* Emergency Contact Phone:

Medications:
Medical Conditions:

* Insurance Company:
* Policy Number:

In signing this application, I release Gettysburg College and other involved parties from any claims or responsibility for injuries suffered in the camp. I knowingly assume all risks associated with participation and assume full responsibility for my participation. I certify that I am in good physical condition and can participate in the College Bound Soccer Camp. Further, I authorize the site director to request medical treatment as necessary to insure my well-being.

* Signature of Parent:

Gettysburg College