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Recruit ID Clinic

(*) denotes required information.

Clinic Registration Fee: $115.

 
* First Name:
* Last Name:
* Address:
* City:
* State:
* Zip:
* Graduation Year:
* 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 300 North Washington Street · Gettysburg, PA 17325
P: 717.337.6300