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Parent Info
Parent Name
(Required)
First
Last
Parent Email
(Required)
Parent Phone
(Required)
Player Info
Player Info
Player's Name
Player's Birth Date
Current Club/Playing Experience
Actions
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Players.
Add Player
Maximum number of players reached.
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Player Count
Emergency Contact
Emergency Contact Person
(Required)
First
Last
Emergency Contact Phone Number
(Required)
Emergency Contact Email
Camp Selection
Camp
Quantity
(Required)
Price:
$0.00
Quantity
Which camp session(s) are you interested in?
(Required)
Franklin Junior Camp 9am - 12pm June 2-6
Franklin Advanced Summer Camp 9am - 3pm June 16-20
Brentwood Advanced Summer Camp 9am - 3pm July 14-18
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Camp Count
Discount
$0.00
Total
Consent
Parent Signature:
(Required)
Consent
(Required)
RELEASE: In case of emergency when I cannot be reached, I authorize the staff of Londono Soccer to obtain whatever medical treatment deemed necessary for the welfare of my child. I further understand and agree that I will be financially responsible for all charges and fees incurred in the rendering of said emergency treatment, regardless of whether or not my medical insurance would cover such charges and fees. I hereby give my consent to my child's participation in the activities of Londono Soccer and hereby absolve, release, and hold harmless Londono Soccer and all of its officers, directors, shareholders, agents, representatives, attorneys, employees, owners, successors, assigns, and other affiliates from any and all liability for any injuries or damages that my child may suffer in connection with the activities sponsored by Londono Soccer or in which my child may participate.
I agree to the release.
Payment
Payment Method
(Required)
PayPal Checkout
Credit Card
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MasterCard
Visa
Supported Credit Cards: Discover, MasterCard, Visa
Card Number
Expiration Date
Security Code
Cardholder Name
Comments
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