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2024 Youth Soccer Camp
Registration form for the 2024 Washburn High School Youth Soccer Camp
1
Contact Information
2
Camper Information
3
Waiver/Emergency Contact
4
Payment
Contact Information
Primary Contact Name
*
Who should we be in contact with regularly about the registered camper?
First
Last
Primary Contact Email
*
Primary Contact Phone
*
Address
*
Street Address
City
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Camper Information
Name of Camper
*
Name of the child who is being registered for camp. If you have more than one child being registered, you will need to complete a registration for each one.
Date of Birth
*
MM slash DD slash YYYY
Grade (in Fall 2023)
*
What is the camper’s grade for the school year beginning this coming fall?
Kindergarten
1st
2nd
3rd
4th
5th
School
*
School the camper will be attending this coming fall
Annunciation
Armatage
Bancroft
Barton
Burroughs
Carondelet
Field
Hale
Homeschool
Kenny
Lake Country
Lyndale
Meadowbrook
Our Lady of Peace
Richfield STEM
Windom
Yingua Academy
Other (Not Listed)
T-Shirt Size
*
Youth Small
Youth Medium
Youth Large
Adult Small
Friend/Sibling Request
Does this camper have any friends or siblings attending the camp AND would like, if possible, to be paired with them? If so, please list any friends or siblings
Health Issues
*
Does this camper have any allergy or health concerns that we should know about?
Yes
No
Health/Allergy Concerns
Please let us know about any allergy or health concerns about this camper
Emergency Contact Information & Waiver
Name of Person to Contact in Case of Emergency
*
Emergency Contact Phone
*
Waiver Signature
*
Type your name to indicate agreement to the following: My child has permission to participate in the Washburn High School 2023 summer youth soccer camp. I hereby release and/or otherwise indemnify Washburn High School and its associated coaches and players against any claim by or on behalf of my child.
Payment
Youth Soccer Camp Registration Cost
*
Price:
Discount Code
The discount code is supplied solely by Washburn Soccer Boosters after confirming a family qualifies for a discount.
Washburn Soccer Camp Registration
Total cost, including any applied discounts
$0.00
Credit Card
Card Details
Cardholder Name
Email
This field is for validation purposes and should be left unchanged.
Δ
Home
About
About the Boosters
Coaching Staff
Contribute
Volunteer
Sponsorships
Contact
Tryouts
Register
The Basics
Team Structure and Selection
FAQs
Teams
Varsity
Junior Varsity
Academy A
Academy B
Photos
Events
All Events
Games (All Teams)
Sylvester Cup
Super Soccer Saturday
Soccer Camps
Girls
Email
Facebook
Flickr
Twitter