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2012 GOALS Soccer Camp Application

SULLIVAN FIELD
Los Alamos, NM

Please download, print, complete and send along with deposit
and medical form to GOALS Camp address!

SOUTHWEST HEADQUARTERS
2165 Deer Trail
Los Alamos, NM 87544

Name _________________________________ Entering Grade ___________
Street _________________________________ City ____________________
State/Zip_______________________________ Date of Birth_____________
Home Phone ____________________________ Cell Phone_______________
Name of Parent/guardian __________________ Please sign me up for the following:
Soccer Program (HS/Club)______________________________


___ Sullivan Field

July 30th-August 3rd
8:45am - 2:30pm

Tuition
$255.00 before May 31st
$280.00 after May 31st

Years attending Goals______________________
Email contact____________________________

____ I wish to participate exclusively in the Goalkeeper-Within-A-Camp

 

DEPOSIT INFORMATION


A $125 non-refundable
deposit must accompany
this application. Upon receipt, all pertinent camp information will be forwarded to you.


(800) GOALS-33
www.goalscamp.com

Please print medical form and transportation waiver and submit along with application/deposit!

My daughter is in good health and may participate in all camp activities. In case of an emergency, I grant permission for my daughter to be given emergency treatment at a
local hospital.

Parent Signature_____________________________________