Summer Camp Form - RDT Soccer Academy

August 5 to 09 for 7-9 year olds - August 19 to 23 for 9 - 12 year olds

Summer Camp Form

Child’s Name:

Date of Birth

Child’s Gender

Boy Girl

Parent / Guardian Names

Address and Postal Code

Phone Numbers

Week

Registration Cost: $350

Date Paid

Emergency Contact Name

Emergency Contact Phone Number

Medical Concerns or Allergies

Please read and sign the Waiver Below.

I hereby for myself, my heirs, executors, administrators and sponsors waive and release all rights and claims that may arise against the RDT – Mini Soccer League. I waive and release its affiliated associations, sponsors, agents, or representatives, for any and all injuries or losses suffered while competing in or connection with the leagues and programs of the RDT-Mini Soccer League. Pictures of the sessions may be taken during the season; These pictures may be used on our website or promotional materials.

Waiver Signature:

Date