DSSC Summer Soccer
What to Bring Each Day
Soccer Ball, Water, Cleats and Shin Guards
Location
Mingo Park
Player's First Name:
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Player's Last Name:
*
Player's Gender:
*
Male
Female
Player Age:
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8
9
10
11
12
13
14
Parent Name:
*
Phone Number:
*
Emergency Number:
*
Email:
*
Skill Sessions ($10 each - Select all you will attend)
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Shooting - June 16th 4:30-6:15 pm ($10)
Defending - June 17th 4:30-615 pm ($10)
Attacking - June 18th 4:30-6:15 pm ($10)
Moves/Turns - June 19th 4:30-6:15 pm ($10)
Chipping/Trapping - June 23rd 4:30 - 6:15 pm ($10)
Passing - June 24th 4:30 - 6:15 pm ($10)
Juggling/Heading - June 25th 4:30 - 6:15 pm ($10)
Dribbling - June 26th 4:30 - 6:15 pm ($10)
Goal Keeper - June 23rd - June 26th 2:30 - 4:00 pm ($30)
I would like to order a camp t-shirt:
None
Youth Small
Youth Medium
Youth Large
Adult Small
Adult Medium
Camp Fee:
T-shirt Fee:
Paypal Fee:
Total Fees Due:
Release of Liability: By registering my child and returning both the payment and registration form as required, I/we hereby acknowledge, on behalf of all participants, in my/our immediate family, that I/we and my/our legal heirs, individually and as the parent(s)/legal guardian(s) of the player/participant, do hereby waive and release all rights and claims for losses or damages that I/we and the player/participant may have against the Delaware Youth Athletic Association, its officials, sponsors, hosts, representatives, and administrators, Patrick Miller and any/all assistant coaches or camp staff for any and all injuries suffered by me/us and/or the player/participant in connection with participation in this program and all its events. I/we and the player/participant assume all risks of injuries, losses, and damages in connection with such participation.
I agree to the liability release statement:
*
Yes
