CHS SOCCER CAMP

Hosted by CHS Girls Soccer Team & Staff

When: Monday, July 20th and Tuesday July 21st

Rain-out Dates: July 22nd - 23rd
Candy League: 6 pm – 7:30 pm Cost: $20
All other divisions: 6 pm – 8 pm Cost: $25 ($20 each additional sibling)
(T-shirt included with registration)
Where: Carlisle SAY Soccer Fields
Please bring a ball and a full water bottle and wear cleats and shin
guards every night!
Please detach and mail registration form and payment by June 30th to:
Jenny Henry 150 Nattix Crt. Carlisle, Ohio 45005
(checks should be made payable to: Carlisle Athletic Boosters)
Late or on-site registrations accepted but T-shirt sizes may be limited

For questions contact Jenny Henry at 746-8789 or Heather Allison at 743-0718

(keep top portion for your information)

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Player Name:_________________________________________________________

Address:_________________________________________________________

City:__________________________ State:______________ Zip:___________

Date of Birth:_____________________ Age: ________

Parent/Guardian Name:________________________________________________

Parent/Guardian Home Phone:__________________ Cell Phone:__________________

Shirt Size (circle one): YS (6-8) YM (10-12) YL (14-16) AS AM AL

AXL

Emergency Phone Number (in addition to numbers given above):

Name: __________________________________ Number: _____________________

Please initial one of the following options and sign:

_____ In the event that I cannot be reached should a medical problem arise, I hereby give my consent
for treatment to the above named minor (including surgery, X-ray examinations and anesthesia) by a
licensed medical practitioner.

_____ I authorize limited care as follows:

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Parent/Guardian Signature _____________________________ Date ___________