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Soccer Camp 2019 August 19 - 23
Please fill out this registration for for your child
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* Indicates required question
Email
*
Your email
Camper Name
*
Your answer
Camper Age
*
Your answer
Male or Female
*
Male
Female
Please list any allergies
Your answer
Please Send your camper with lunch & Water bottle
*
I will send my camper with lunch and a water bottle
List any other health problems/important information
Your answer
Shirt Size
*
Youth Small
Youth Medium
Youth Large
Small
Medium
Large
Parent / Guardian Name
*
Your answer
Address
*
Your answer
Phone Number
*
Your answer
Emergency Contact Name and Number
*
Your answer
I authorize the above mentioned to pick up my child if needed
*
Yes
No
Required
I authorize my child to be photographed by Athletes In Action
*
Yes
No
Required
Please indicate method of payment
*
Cash (To be delivered to Westlock Alliance Church)
Cheque (To be delivered to Westlock Alliance Church)
Push Pay
Pushpay Link:
https://pushpay.com/g/westlockalliancechurch?src=hpp
Select the option "Other Donation" Then Write "Soccer Camp" in the memo box.
A copy of your responses will be emailed to the address you provided.
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