Summer Camp - August 9-13, 2021  9-11 am
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Player's First Name *
Player's Last Name *
Birth Year *
Parent's First & Last Name
Cell number in case of emergency:
(Mom 555-2000) (Dad 555-2001)
T-shirt Size *
Emergency Phone Contact & Name of Contact *
Who would you like us to contact in case of emergency?  A cell phone contact would be extremely helpful.
Email *
This will not be used for solicitation. This is so that we may contact you with any questions or updates more efficiently.
WAIVER- by printing your name, you agree to the following:  I hereby give my child permission to participate in the S.C.O.R.E. camp. I certify that s/he is physically fit and capable of participation in strenuous physical activity. I hereby release, discharge and, or indemnify Milwaukee Sport Club, the director, and the staff against any claim as a result of my son's or daughter's participation in the camp. In case of emergency, I grant permission for my son/daughter to be treated at a local hospital. I hereby give permission for Milwaukee Sport Club to use any pictures or video that may be taken during camp to promote soccer without consideration or fee. *
Please type your name & date into the box below, to show that you agree to the waiver.
Camp cost:  $90 --  I have submitted payment. *
Please make checks payable to: Nicole Nowicki  & Send payment to:  17085 Gebhardt Road, Brookfield, WI 53005
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