Griffin Soccer Registration Form - Summer Camps
Questions? 408-446-0618 |
Summer Camps 2017
June 12-16 - Half Day (9 AM to noon) $225/week or $50/day
June 12-16 - Mini Camp (9 AM to 10:30 AM) $125/week or $30/day -- recommended for 5-6 year olds
July 17-21 - Half Day (9 AM to noon) $225/week or $50/day
July 17-21 - Mini Camp (9 AM to 10:30 AM) $125/week or $30/day -- recommended for 5-6 year olds
July 31-Aug. 4 - Half Day (9 AM to noon) $225/week or $50/day
July 31-Aug. 4 - Mini Camp (9 AM to 10:30 AM) $125/week or $30/day -- recommended for 5-6 year olds
What days of camp will your child attend?
Full Week (Monday to Friday)
Date of Birth
Age as of camp's start date
Grade in School
Current Level of Play
Club - Competitive
Club - Recreational
AYSO - All Star
New to soccer
If you play for a club or team, what is the name?
Last name, First Name
Emergency Contact Information
Emergency Contact (Last Name, First Name)
Emergency Contact's Phone Number
Insurance & Medical Information
Insurance Company Name
Please indicate any other medical conditions, special needs, or behavioral conditions the coaches should be made aware of for camp
If your player would like to be grouped with a friend or teammate, what is their name?
How did you hear about this camp?
Griffin Soccer's White Truck
Sunnyvale Alliance Soccer Club
I certify that my child is in excellent physical health, and may participate in strenuous and hazardous physical activities, including the soccer and futsal to be played under the direction of Griffin Soccer (GS). I certify that there are no physical limits to my child’s participation. I understand that accidents and injuries can arise from participation; knowing the risks, nevertheless, I hereby agree to assume those risks on behalf of the above named Minor and to release and to hold harmless all of the representatives of the GS. Permission is granted for my child to receive emergency medical treatment if needed. I will be personally responsible for any damages sustained by my child and any invited family participants to any GS equipment and/or any indoor or outdoor facilities rented by GS.In consideration of participation in the program offered above, I, the undersigned, as the parent/guardian of the Minor named above, agree to indemnify and hold GS and its rented facilities harmless and hereby waive, release and discharge any and all claims for damage, for death, personal injury, bodily injury or property damage which I and/or the Minor may have or which hereinafter may accrue to me and/or the Minor against GS and may rise out of negligence or carelessness on the part of GS. For players on soccer teams, my child has his/her coach’s permission to participate in the GS soccer and futsal program. I agree to allow use of photography and videography of my child for publicity. It is understood and agreed that this waiver, release and assumption of risks has been freely entered into and is to be binding on my heirs and assigns. I represent that I am a parent/guardian of the Minor named above and I agree that the grant and release contained therein binds me and the Minor to all its terms.
Yes, I agree.
Half Day Camp (9 AM to noon) is $225/week or $50/day;
Mini Camp (9 AM to 10:30 AM) is $125/week or $30/day
Check, Credit Card or PayPal?
Check: Mail check payable to "Griffin Soccer" to: Griffin Soccer, PO Box 2047, Cupertino, CA 95015-2047
Cash: drop off on first day of camp
Credit Card: a Square invoice will be sent to the email address used for this registration
PayPal: send payment to
with child's name in the "Notes" section
Financial Aid: please enter the financial aid code you received in "Total Due" field below
A copy of your responses will be emailed to the address you provided.
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