Starting XI Summer Camp

Who is filling out this form? *

Parent/Guardian

Trainee

Name *

First Name

Last Name

Phone *

(###)

###

####

Trainee's Name *

First Name

Last Name

Trainee's date of birth *

MM

DD

YYYY

Trainee's position *

Field Player

Goalkeeper

T-shirt size

Youth/S

Youth/M

Youth/L

Adult/S

Adult/M

Adult/L

Camp dates you want to attend

(Field Players Only)

July 14th-16th

July 21st-23rd

Both

Have you signed our WAIVER form? *

Yes

No