Soccer In USA - Empoli Camp Registration

Recent News



	8/28/2010

	Great scholarships available! NCAA Division 1 college looking for 5 women players for their 2011 program. Either fill out your resume by registering with SoccerInUSA or contact us through email.



	8/21/2010

	Strong NCAA Division 1 college looking for a central defender, a left midtfielder, and an attacker. Click registering for more information and to register.

Empoli FC Soccer Camp Registration

Please fill out the form below to register for Empoli FC Soccer Camp.

Age Group

Girls 8-12 years of ageGirls 13-19 years of age
Boys 8-12 years of ageBoys 13-19 years of age

Player Information

First Name    Last Name

Gender

Birthdate (Month) (Day) (Year - 4 digit)

Address

City    State Choose 'Other' if outside US!

Zip    Country

Phone    Type

Email

T-shirt size Youth SmallYouth MediumYouth Large
Adult SmallAdult MediumAdult Large

Note to Camp Directors

Parent Information

Parent #1

First Name    Last Name

Email

Home Phone    Work Phone

Cell Phone

Parent #2

First Name    Last Name

Email

Home Phone    Work Phone

Cell Phone

Medical Information

Medical insurance company

Medical insurance policy #

List any medical concerns (allergies, asthma, e.g.)

Doctor's name

Doctor's phone number

Emergency Information

Emergency Contact Person #1

Name

Phone

Emergency Contact Person #2

Name

Phone

Release And Agreement

Release and agreement: I, the parent of the player named hereon acknowledge that participation in the sport of soccer, as in any sport, may result in injury. I hereby release Sports in USA, Inc., its Agents, Coaches, and staff from all liability or responsibility for any claim, damage, or legal action on behalf of the player or the player’s parents, heirs, or personal representatives arising from any injury the player may sustain while participating in soccer or related activities. I hereby authorize the staff of the Sports in USA, Inc. to act for me according to their best judgment in any emergency situation requiring medical attention. I give my consent for emergency medical care prescribed by a licensed doctor of medicine or dentistry. I, also, understand Sports in USA, Inc. retains any right to use in documenting the activities of Empoli Soccer Camp, for educational and promotional purposes, photographs or video of campers taken at camp. Sports in USA will NOT be responsible if it is unable to commence, continue or completely perform its obligations hereunder by reason of force majeure, fire, flood, hurricane, Tropical Storm, typhoon, aircraft damage, war, state of national emergency, local or USA Government action or any cause whatsoever (whether or not of similar nature to the forgoing) which is not within its control.

I agree to the above release and agreement.

IMPORTANT NOTE: Submission of an application and payment does not guarantee acceptance to the camp. Upon acceptance, a confirmation will be forwarded to you. If not accepted, your payment will be reimbursed in full.

Cancellation Policy: If cancelled prior to June 21st, you will receive a full refund, minus a $50 administration fee. After June 21st, you will receive a credit for next year, minus a $50 administration fee.

Camp Dates and Payment

$235.00 Empoli Soccer Day Camp Week of July 6-10 2009 Orlando
$385.00 Empoli Soccer Day Camp With Lunch July 13-17 2009 Cocoa
$595.00 Empoli Soccer Full Board Camp Week of July 13-17 Cocoa
$1950.00 TEAM Session Day Camp July 6 -10 2009 Orlando (10 Players Minimum)
$1950.00 TEAM Session Day Camp July 13-17 2009 Cocoa (10 Players Minimum)

We accept the following payment options: