Emmanuel Baptist Church Soccer Camp Preregistration Form
June 18, 19, 20 2019
12:30 pm - 3:00 pm
Located at Emmanuel Baptist Church in Rochester
This is a free soccer camp to all kids from kindergarten thru 6th grade. We have Professional Brazilian Coaches training the children and there is no charge for the camp.
Emmanuel Baptist Church Annual Free Soccer Camp
Child's First Name *
Your answer
Child's Last Name *
Your answer
Child's Grade in the Fall *
Child's Age *
Your answer
Parent/Guardian First Name(s) *
Your answer
Parent/Guardian Last Name *
Your answer
Parent/Guardian Email Address *
Your answer
Street Address *
Your answer
City *
Your answer
Zip Code *
Your answer
Phone *
Your answer
Emergency Contact Name *
Your answer
Emergency Contact Phone Number *
Your answer
Who will be Picking up and Dropping off The Child? *
Your answer
Please List any Allergies and Medical Conditions that we should be aware of
Your answer
I will fill out a Parental Consent/Participation Form the first day of camp *
Required
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