Soccer Camp Sign-up
Saturday, March 28 from 10am-Noon
Southern Wesleyan University's Gilbert Track and Field
On the corner of Clayton St. & Wesleyan Dr.
Parent/Guardian's name *
Parent/Guardian's email that the waiver should be sent to *
Emergency phone number(s) (put as many as you would like, but at least one is required *
Child's name *
Child's age *
Child's height & weight *
Allergies? (outdoor, food, etc.)
Medical condition(s)? (i.e. asthma)
Current medication(s)?
Hospital Insurance? *
Insurance company (if the child has no insurance coverage type "None".) *
Policy number *
Please click "Submit" below to finish this sign-up. After that, Pastor Jonathan Harris will send you an email with an electronic waiver you must sign to complete the registration process.
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