BSC Summer Camp Registration 2019
Babylon Soccer Club and Maximum Potential Training are hosting a 1-week summer camp, August 12 - 16, 2019
- 3 hour camp for children 6+
- 90 minute camp for children 4 & 5 years old

To register for the camp:
1. Fill in and submit the registration form below (fill in a separate entry for each child)
2. Submit payment here:

Email address *
Based out of Smithtown, Long Island and led by NSCAA Premier, US National Youth and USSF A licensed coach, Erin Bradbury, Maximum Potential is a company centered on a coaching philosophy which ensures maximum ball contact, great fun, guided discovery tasks that treat all players as problem solvers. We present the game in a way which ensures that all players enjoy pushing themselves in each practice eager to express their ideas and skills learned. All camp staff are trained in the unique Maximum Potential coaching method and have vast teaching experience in the game. All campers are guaranteed a challenging and fun week.

The camp will be held at the Babylon Grade School, 169 Park Ave Babylon, NY at the times selected on this registration form.

To ensure all players have a fun and challenging time the camp schedule is divided into the following components:
-- Street Soccer 3v3 games
-- Ball mastery and 1v1 games
-- Shadow Play to imprint style of play
-- Technical-Tactical Skill of the Day
-- World Cup Day
-- Age appropriate tactical discussions at break
-- Competitive end of day games

All campers on both the 3 hour and 90 minute camp should ensure they bring the following to each day of the camp:
-- Age appropriate inflated ball
-- Soccer cleats & shin guards
-- Plenty of water to drink
-- Soccer appropriate attire
-- Healthy snacks
-- Wet weather top in case of showers

Please email any questions to

Please fill in a separate entry for each child. All form fields are required.
Player First Name *
Your answer
Player Last Name *
Your answer
Player Age on 1st Day of Camp *
Your answer
Player Current or Former Club Team (if none, type none) *
Your answer
Please check the box or boxes below to indicate which camp the player would like to attend. *
Camp T-Shirt Size *
Medical Release and Waiver of Liability
As the parent/legal guardian of the registrant, I request that in my absence the above named player be admitted to any hospital or medical facility for diagnosis and treatment. I request and authorize physicians, dentists, and staff, duly licensed as Doctors of Medicine or Doctors of Dentistry or other such licensed technicians or nurses, to perform any diagnostic procedures, treatment procedures, and operative procedures and x-ray treatment of the above named minor. I have not been given a guarantee as to the results of examination or treatment. I authorize the hospital or medical facility to dispose of any specimen or tissue taken from the above-named player.

WAIVER OF LIABILITY, the parent/guardian of the registrant, a minor, agree that I and the registrant will abide by the rules of Babylon Soccer Club and Maximum Potential and its staff. Recognizing the possibility of physical injury associated with soccer and in consideration for Maximum Potential accepting the registrant for its soccer programs(the “Programs”), I hereby release, discharge and/or otherwise indemnify Maximum Potential, its Directors, their employees and associated personnel, including the owners of the fields and facilities utilized for the Programs, against any and/or all claims by or on behalf of the registrant as a result of the registrant’s participation in the Programs

By entering your name and date below, this certifies you have read and agreed to the terms above.

Parent or Guardian Full Name *
Your answer
Parent or Guardian Emergency Phone Number(s) *
Your answer
Date of Signature *
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