Registration Form
The form registers your child for "Ascension Soccer Camp" on Monday, Tuesday, and Wednesday, June 24th, 25th, and 26th from 9am-12pm each day. The event is for all children, ages 7-12. Please note the hold harmless wavier at the end which must be signed in person the first day of the event (Monday). 

Plan on dropping off and picking up your child each day at: 
1500 Peterson Ave. 
Eau Claire, WI 54703.

Monday registration: 8:30am
Tuesday drop off: 8:45-9:00am
Wednesday drop off: 8:45-9:00am

The cost for the event is $10. This includes a t-shirt, snacks, and drinks for every child. To guarantee a t-shirt, registrations need to be in by Friday, June 14th. Due to the turnaround time with our screen printer, any registration received after June 14th is not guaranteed a t-shirt. 

Please fill out the form below - one for each child attending. 
Please contact Pastor Lloyd Harter with any questions you might have. His contact information is:
(847) 257-6479
pastor.lloyd.harter@gmail.com
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Email *
Child's First and Last Name:
Child's Age:
Child's T-shirt Size (children's sizes):
Parent/Guardian's Name:
Parent/Guardian Address:
Phone:
Who, other than you, will be picking up the child? 
Do you have a home church? If yes, where?
Does your child have any allergies (food or otherwise) or specific needs we should be aware of? 
I agree to the following waver which I am also willing to sign in person the first day of the soccer camp:

I hereby give my consent as the parent/guardian of this child to participate in Ascension Lutheran Church’s Soccer Camp on June 24-26, 2024, held at Ascension Lutheran Church and the fields of Crestview Academy.  My child and I hereby release, indemnify, and hold harmless the church’s and Crestview Academy's employees and volunteers from any and all liability for any claim, injury, or loss sustained by my child’s participation in Ascension Soccer Camp activities.  I hereby testify that my child is healthy enough to participate in the soccer activities. In the event of an emergency, the staff has my permission to seek necessary medical treatment for my child.
I give permission for pictures/video of my child to be used in advertising of Ascension and Pinehurst Lutheran Church.
A copy of your responses will be emailed to the address you provided.
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