Stars and Stripes Soccer Academy Summer Camp 2017 Registration
Please complete all of the information below. Once you submit your completed registration form, you will receive a confirmation email with full payment details. Thank you for choosing Stars and Stripes Soccer Academy. We look forward to seeing you on the field.
Camper's Name (Last, First) *
Your answer
Date of Birth *
Your answer
Parent/Guardian Name *
Your answer
Street Address *
Your answer
City, State *
Your answer
Zipcode *
Your answer
Email Address *
Your answer
Home Phone *
Your answer
Cell Phone *
Your answer
Current Team/League *
Your answer
Current School Attending *
Your answer
School Attending in Fall 2017 *
Your answer
Select T-Shirt Size *
Emergency Contact Name *
Your answer
Emergency Contact Phone Number *
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Doctor's Name *
Your answer
Doctor's Phone Number *
Your answer
Insurance Company *
Your answer
Any allergies or medical information? *
Your answer
Check Selected Session(s): *
Required
Preferred payment method: *
Full payment information will be provided through a confirmation email once registration is completed.
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