You are on page 1of 2

2015 Castle High School

Boys Soccer Youth Camp

S
E
G
A
Boys
K-5th Grade
(As of the 2015/2016
School year)

When: June 22,23,


and 24
9 AM11 AM
Where: Castle High
School Soccer Fields
Cost: $45.00 per camper on site/ $35 if payment
is mailed in before June 1.
Application and check can be mailed to:

Questions???? Contact Coach Reiter: Mike Reiter


mreiter@warrick.k12.in.us

3666 Katalla Dr
Newburgh, IN 47630

--- ------- ------------------------------------- ----- ----- ---Application (Mail this portion in with your check)
Campers Name: ___________________________________
Campers Grade in School (Fall of 2015): ____________________________________
Parents/ Legal Guardians names: __________________________________________
Emergency Contact Information: __________________________________________
WE AS PARENTS OR GUARDIANS HEREBY GIVE PERMISSION FOR OUR SON TO PARTICIPATE IN THE
CASTLE HIGH SCHOOL SOCCER CAMP AND ACKNOWLEDGE THE FACT THAT HE IS PHYSICALLY ABLE
TO PARTICIPATE IN CAMP ACTIVITIES. WE UNDERSTAND AND AGREE THAT MIKE REITER AND HIS
STAFF SHALL PROVIDE ONLY EMERGENCY MEDICAL TREATMENT FOR ANY INJURIES SUFFERED AND
I/WE ASSUME FULL RESPONSIBILITY FOR ALL MEDICAL EXPENSES INCURRED AS A RESULT OF PARTICIPATING IN THIS CAMP.

SIGNATURE OF PARENT OR GUARDIAN__________________________________

You might also like