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Community Summer Soccer Camp July 17th-20th (8:00 a.m. -11:00 a.m. @ Fairplay Park, 312 S Walnut St, Roanoke) Ages 5-15
Please fill out the form to sign up your child for the soccer camp. An email will be sent out with first day details one week before the camp start date. Please email me at
philipsalyer@gmail.com
with any questions
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Email
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Camper's First Name
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Camper's Last Name
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Camper's Date of Birth
mm/dd/yyyy
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Parent #1 First and Last Name
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Parent #1 Cell Phone Number
xxx-xxx-xxxx
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Parent #2 First and Last Name
Optional
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Parent # 2 Cell Phone Number
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Parent #2 E-mail Address
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Address
address, city, zip code
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Medical Information
If none type NA
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Payment Options
Camp Cost is $150 for the full camp and $75 for those 5 years old and under only participating until 1000 a.m.
Pay by Venmo to @Philip-Salyer ($150)
Email to arrange another form of payment ($150)
Pay by Venmo to @Philip-Salyer ($75/ 8:30 a.m. to 10:00 a.m.)
Email to arrange another form of payment ($75/ 8:30 a.m. to 10:00 a.m.)
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