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.
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy