2017 Annual Hoover Youth Soccer Camp
Monday June 12th – Thursday June 15th
6:00 p.m. to 7:30 p.m.
Clearmount Elementary School
Age Group: Current 2nd – 7th grade students in this Area.
(Current 8 grade students that will be playing high school soccer this fall should not sign up for this camp)
th
Cost: $40.00 (includes camp T-shirt)
REGISTRATION DEADLINE: June
1st
Varsity and JV coaches along with varsity players from both the Boys and Girls soccer programs will be on
hand to work with this age group of future soccer players.
________________________________________________________________________________
PLAYER’S LAST NAME
FIRST NAME
_______________________________________________________________
___________
CITY
ZIP CODE
_____ Female
___YM ____YL____AS____AM____AL____AXL
MAILING ADDRESS
___________________
_____ Male
MIDDLE INITIAL
T-SHIRT SIZE
(_______)________-__________
PHONE NUMBER
_______
GRADE
____________________
SCHOOL (Fall 2013)
__________________________________________________________________________________________
FATHER’S NAME
E-MAIL
CELL NUMBER
__________________________________________________________________________________________
MOTHER’S NAME
E-MAIL
CELL NUMBER
__________________________________________________________________________________________
PERSON TO NOTIFY IN CASE OF EMERGENCY
RELATIONSHIP
PHONE NUMBER
NORTH CANTON SCHOOLS INSURANCE WAIVER
This is to certify that my son/daughter has full medical and hospital coverage through a family protection
policy, and that I will assume full responsibility for medical expenses that might occur in athletics.
Please list any pertinent details of the player’s medical history allergies, medications, physical ailments,
surgeries, etc.______________________________________________________________________________
Signature of Parent: _________________________________________________ Date:_________________
Please make checks payable to North Canton Soccer Booster Club (NCSBC) and mail registration
with enclosed fee to:
North Canton Soccer Booster Club
Youth Summer Camp
PO Box 2343
North Canton, Ohio 44720
For any questions or concerns please contact the North Canton Soccer Booster Club at
[email protected]