Ulster Football Club Day Camp Application -2018
This Soccer Day Camp for basic/intermediate/advanced soccer skills is run by Professional Instructors Victor Cymbal- Rondout High School Boys Varsity Soccer Coach, USSF “D” license and Dmitri Mazur- Rondout Modified Soccer Coach, former European Professional, played for Karpaty Lviv & others. Ages: 8-17 (+/- one year depending on level)
Email address *
Camp Information
Session 1: August 6-10, 2018
Session 2: August 13-17 2018
9am to 4pm.

Total fee for camp:
$250/week - if paid by 7/31
$280 after 7/31, or $60 per day
For More Info: email: vcymbal@hotmail.com or cell#: 646-584-7764

Please send full payment to:
Dmitri Mazur
35 Clay Hill Rd.
Kerhonkson, NY 12446

All Camp forms (Camp registration, permission and medical forms) should be emailed to UlsterFootballClub@gmail.com or mail with your payment to Dmitri Mazur, 35 Clay Hill Rd. Kerhonkson, NY 12446

Camper's Full Name *
Your answer
Date of Birth *
Your answer
Gender *
Address *
Your answer
City *
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State *
Your answer
Zip Code *
Your answer
Parent/Guardian Full Name *
Your answer
Phone - Home *
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Phone - Cell *
Your answer
Camper's T-shirt Size *
Camp Medical Forms
Please note that all medical forms MUST be received PRIOR to the start of camp. No Child will be permitted to participate in camp without completed medical forms from your family physician. Camp medical forms can be download on our website. http://www.soyuzivka.com/camps.html
Full Registration Requirements
I understand that my child will not be fully registered for camp until payment and medical forms are received.
A copy of your responses will be emailed to the address you provided.
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