Pilchuk Side Soccer Camp
Event Dates: August 9th - 11th
Event Times: 9am-Noon
Event Address: Stocker Fields, 27th Avenue Snohomish
This 3-day camp is $300 (includes an exclusive camp t-shirt). Payment can be made using Venmo @twiintekk-soccer or by paying in cash at the event.

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Email *
Athlete First and Last Name *
Parent First and Last Name *
Phone *
Soccer club or program your athlete is currently with. *
Position *
# of years playing *
What days will your athlete attend? *
Required
Shirt size  (youth) *
I, the undersigned parent/guardian of the individual named above, a minor, do hereby agree to participate in the aforementioned activity. It is understood that participation involves an element of risk and a danger of accidents. Knowing those risks, I hereby assume those risks. In additional, I understand that by signing this agreement, I hereby release and discharge Twiintekk and its trainers from any and all liability resulting in injury associated with the camper’s participation I this activity. I understand it is my responsibility to inform camp personnel of any medical conditions, allergies, food restrictions or any other special needs my son/daughter may have. In the absence of a parent/guardian’s signature below, payment of fees and participating in the program shall constitute acceptance of the conditions set forth in the release. I further grant Twiintekk and its trainers and employees the right to photograph or video my dependent and use the photo/video or other reproduction of his/her likeness for publication processes, whether electronic, print, digital or internet. *
Required
Any athlete even suspected of suffering a concussion should be removed from the game or practice immediately. No athlete may return to activity after an apparent head injury or concussion, regardless of how mild it seems or how quickly symptoms clear, without medical clearance. Close observation of the athlete should continue for several hours. The new “Zachery Lystedt Law” in Washington State now requires the consistent and uniform implementation of long and well-established return to play concussion guidelines that have been recommended for several years: “A youth athlete who is suspected of sustaining a concussion or head injury in a practice or game shall be removed from competition at that time.” AND “may not return to play until the athlete is evaluated by a licensed health care provider trained in the evaluation and management of concussion and received written clearance to return to play from that health care provider. ”You should also inform your child’s coach if you think that your child may have a concussion. Remember it is better to miss one game than to miss the whole season. When in doubt, the athlete sits out! For current and up-to-date information on concussions you can go to: http://www.cdc.gov/ConcussionInYouthSports/ *
Required
I understand that I will have to pay upon arrival using Venmo or cash. *
Required
A copy of your responses will be emailed to the address you provided.
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