Registration Information Camp Date(s) August 9-13 Full Day - $175 Half day -$100/$80 Aug 16-20 am pm Full Day - $200 Half day - $125/$100 Aug 23-27 am pm Full Day - $200 Half day - $125/$100 am pm Extended Care Needed (8-9am / 3-5pm) Aug 9-13 Aug 16-20 Extended Care AM PM Week $25 Aug 23-27 day M T W T Summer Soccer Camps F $5 Please attach a separate schedule for each week of extended care, if needed Child’s Information Name Address Age Primary Contact Name Phone Cell August 9 - 13 August 16 - 20 August 23 - 27 Secondary Contact Name Phone Cell CAMPS AT GORGE SOCCER ASSOCIATIONS HAMPTON PARK NEW TURF AND CAGE Age group and club played this year Phone for more information: Email (250)384-2896 All correspondence/receipts/updates will be sent by email. PLEASE PRINT LEGIBLY Victoria BC Phone: (250) 384-2896 Additional information: www.unitedsoccer.ca Visit our website www.unitedsoccer.ca United Soccer Solutions Summer Soccer Camps USS IS PRESENTING THREE WEEK LONG SUMMER CAMPS THIS AUGUST United Champions USS offers 1 week of United Champions that will focus on fun soccer activities for ages 7 to 14. Players are grouped by boys & girls, age, and ability into teams that are under the supervision of our staff coaches. All the staff coaches for our Summer Camps program are schoolteachers, soccer players and coaches, and have been involved in supervising fun Soccer Camps locally for the past several years. A walkable out trip is planned for this week. United Pro This 1 or 2 week program is for players who have demonstrated a proficiency in the game and wish to play in a more challenging environment. Designed to help the serious soccer player prepare for the upcoming season with an emphasis on individual and team development. The curriculum will be designed and coached by our expert staff coaches. This unique program is open to player’s ages 8 to 15 and will also include in-class sessions. A walkable out trip is planned for these weeks. Camps are located at Hampton Park. The majority of the day’s activities will be on the caged Field Turf, Hampton’s main Turf field, and the Field house. All players receive a camp t-shirt. Full day programs run 9am - 3pm Half day mornings run 3 hours (9 – 12pm) Half-day afternoons run 2 hours (1 – 3pm) Singles days are available upon request Before and after care is available for $5.00 per day. Please complete this form, both front and back and return with payment to: United Soccer Solutions 8 Eaton Ave. Victoria, BC V8Z 5E1 August 9-13 (ages 7-14) United Champions (Full Day) $175 United Champions (Half Day) $100 am $80 pm Make Cheque payable to “UNITED SOCCER SOLUTIONS” Medical Information Doctor Phone Care Card # Medical Conditions August 16-20 (ages 8-15) August 23-27 (ages 8-15) Allergies (please list) (please list) United Pro (Full Day) $200 United Pro (Half Day) $125 am $100 pm Register for all 3 weeks and receive $75 off the total camp costs. Register 2 siblings and receive a $50 discount from the 3rd sibling’s camp ~ PLEASE NOTE ~ Registration is limited. Camp payment and registration must be made within one week prior to camp start date. It is understood that United Soccer Solutions associated with the United Soccer Solutions Spring League is not responsible or liable for accidents resulting in medical, dental or other expenses. I/We hereby release and agree to save harmless and indemnify the executive, coaches, managers, referees, assisting and participating parents and others involved United Soccer Solutions Spring League from any and all claims, demands, and suits that may arise in any manner from the above named player participating in the United Soccer Solutions Spring League activities whether or not such claims arise from the actions or conduct of the executive, coaches, referees, managers, assisting or participating parents and others involved in the activities. Participants will be held responsible for all property damage and may be sent home without refund for violations of United Soccer rules and regulations, or because of continual misconduct in the opinion of the United Soccer Staff. I understand and agree. __________________________ Signature of Guardian _____________ Date In the event my child requires immediate medical treatment, I hereby authorize the team officials to seek such treatment. __________________________ Signature of Guardian _____________ Date
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