2022 Desoto FC Soccer Camp Registration Open to children born 2014-2009 -- July 5-8, 8am-Noon, $80 for all 4 days

Campers should bring shin guards, cleats, water bottle and soccer ball. There will be tents for shade, access to restrooms and water for refills for the campers. Cash or check the first day of camp or click here for PayPal.

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* 1. Player Information

Name

Address

City/Town

State/Province

ZIP/Postal Code

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* 2. Player's Date of Birth

Date

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* 3. Player's Gender

Girl

Boy

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* 4. Player's most recent grade completed

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* 5. Parent / Guardian 1

Name

Email Address

Phone Number

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* 6. Parent / Guardian 1 Cell Phone

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* 7. Parent / Guardian 2 Information

Name

Email Address

Phone Number

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* 8. Parent / Guardian 2 Cell Phone

In an emergency when parent / guardian cannot be reached, please contact the following:

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* 9. Emergency Contact 1

Name

Phone Number

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* 10. Emergency Contact 2

Name

Phone Number

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* 11. Please list any allergies the player has:

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* 12. Please list other medical conditions:

MEDICAL TREATMENT AUTHORIZATION AND LIABILITY WAIVER

I hereby give my consent to have an athletic trainer, coach, team manager, emergency medical technician, nurse, medical treatment facility, and/or doctor of medicine or dentistry or associated personnel provide the applicant/participant with medical assistance and/or treatment and agree to be financially responsible for the cost of such assistance and/or treatment. I understand treatment for injury will be based on information provided herein. I hereby authorize emergency transportation of the applicant/participant to a medical treatment facility should an individual listed above consider it to be warranted. I recognize the possibility of physical injury associated with soccer, and hereby release, discharge and otherwise indemnify the team, DCHS, the Soccer Booster club, their sponsors, and their affiliated organizations, and the employees , volunteers, and associated personnel of these organizations, against any claim by or on the behalf of the soccer player named above as a result of that player’s participation in the skills camp program and/or being transported to or from the same, which transportation I hereby authorize.

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* 13. By checking this box, I agree to the statements above

I agree

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* 14. My Relationship to Player

Mother

Father

Guardian