High Power Soccer Camp

July 10-13 | Please fill out this form and click submit.

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This form cannot be submitted until an administrator completes the setup process to receive online payments.

Parent Name

*

Address

*

Email

*

This address will receive a confirmation email

Phone

*

Child's First Name

*

Child's Last Name

*

Grade in 2016-17

*

Please select one option.

pre-K K 1st 2nd 3rd 4th 5th 6th

T-Shirt Size

*

Please select all that apply.

Medium Large

a convenience fee of $1.00 will be added to all online registrations.

Camper Pack one per child

*

Please select all that apply.

Full -$25.00 Returning/Own- & $8 Scholarship requested

Registration Cost

Full ($26) Returning ($9) Pay at registration ($0)

Amount

Credit/Debit Card Number

Expiration Date/CVC

Name on Card

Card Billing Address

Description

July 10-13

Please fill out this form and click submit.

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