REGISTRATION
Deadline May 30
Camper #1 Name
Age: ____ Sex: M   F T-Shirt: YS   YM   YL Ball: 3   4   5
Skill Level:   Beginner   Intermediate   Advanced
Camper #2 Name
Age: ____ Sex: M   F T-Shirt: YS   YM   YL Ball: 3   4   5
Skill Level:   Beginner   Intermediate   Advanced
Camper #3 Name
Age: ____ Sex: M   F T-Shirt: YS   YM   YL Ball: 3   4   5
Skill Level:   Beginner   Intermediate   Advanced
Parents' Names:
Address:
City: State: Zip:
Phone:
Emergency Phone:
E-Mail:
Fees: Ages 5-8 $70 | Ages 9-12 $80

Make checks payable to Silverlake Soccer.
Registration fees include Adidas soccer ball and camp T-shirt.
Liability Waiver
My child is and/or children are in excellent physical health and capable of participation in strenuous physical activity. I hereby give my approval to his or her participation in the SILVERLAKE SOCCER DAY CAMP. I understand that I will be responsible for any injuries to my child/my children resulting from or in connection with camp activities. I hereby release, absolve and hold harmless the SILVERLAKE SOCCER DAY CAMP, its directors, coaches, members, sponsors and supervisors.
Signature:
Mail To: Silver Lake Soccer Day Camp
P.O. Box 85 * Danville PA 17821
Print add'l forms online at www.silverlakesoccercamp.com