Youth Girls Soccer Camp
North Montgomery Chargers
Date: Monday, June 27- Wednesday, June 29th
Time: 9-11:30am
Place: North Montgomery High School Soccer Field
Cost: $25 includes camp T-shirt (late and walk up registration available for $30, but
camper will not receive t-shirt)
Multiple child discounts: $5 off each additional child
Form and payment must be received by Friday, June 17, 2016 to receive camp T-shirt.
The Charger Youth Soccer Camp is open to all girls finishing grades K-5 that attend
North Montgomery Schools. The girls Charger coaching staff as well as members of the
girls high school varsity team will teach basic soccer fundamentals. The camp will
include of a variety of drills and games and each child will get one on one coaching.
Make checks payable to:
NMHS Girls Soccer
For more information please email North Montgomery High
School Head Girls Soccer Coach- Julie Hodges:
[email protected]
Mail to:
North Montgomery High School
Dept. of Athletics- Girls Soccer
5945 N US Highway 231
Crawfordsville, IN 47933
Cut here and mail bottom with payment
-----------------------------------------------------------------------------------------------------------Shirt Size
Youth
Name:
Age & Grade:
School:
Home Address:
Small
Medium
Large
Parents/Guardians Names:
Phone:
Emergency Contact/Phone:
Insurance Company:
Adult
Small
Medium
Large
X-Large
Policy #:
Policy Holder:
Additional Medical Info (allergies, asthma, etc):
I hereby waive and release North Montgomery School Corporation, Camp Directors, coaches and instructors from
all liability for any injuries incurred while participating in the soccer camp for which I am/my child is registering.
I recognize the inherent risks of my/my child’s participations and I assume full responsibility for all injuries. I
know of no mental for physical problems that would affect my/my child’s ability to safely participate in the camp.
I authorize the camp directors or instructors to act for me according to their best judgment in any emergency
requiring medical attention. I also give permission for myself/the above named child to be transported to and
receive medical treatment at a local medical facility, and I guarantee the payment of all expenses incurred for such
transportation and treatment.
All profits from the camp fees may be used for the high school soccer program and/or coaching pay.
Other _______
Parent/Guardian Signature:
Date: