2010 Concordia
Soccer Camp Registration Camp Form
Print
out and send to: Cobber Soccer Camps,
Concordia College,
901 South Eighth St., Moorhead, MN 56562
PLEASE PRINT
CLEARLY
Last _________________________ First __________________________
E-Mail ____________________________________________________________
Address ____________________________
City __________________
State ________________ Zip __________ Phone __________________
T-Shirt Size (S, M, L or XL) Specify Youth or Adult ____________________________
Grade ________________
Age ________ Sex _____________________
I hereby request that you accept the
enrollment of ___________________________________in the 2010 Soccer Camp. I
hereby release the Cobber Soccer Camp Staff, Concordia College and all their
employees and agents from all claims on account of any injuries which may be
sustained by my son/ daughter while attending the camp, and any claims
hereafter which may be presented by my son/ daughter while attending this camp,
and any claims which hereafter may be presented by my minor son/daughter as a
result of any such injuries. I also certify that she is medically fit to
participate in this camp.
_______________________________________________________________
Parent's name (print) Parent's
signature
_______________________________________________________________
Work phone
Home phone
Each camper is
responsible for her own insurance.