KERRIGAN SOCCER SCHOOLS, LLC
SOCCER CAMP AT XL Soccer World
CAMPER APPLICATION FORM
Camper Name: _______________________________________
City:__________________ State:______ Zip:________________
Parents’ Cell Phone(s) : ________________________________
Parents’ Home Phone: ( )_______________________________
Parent’s Work Phone: ( ) ________________________________
Parent’s email: (for camp information only & will not be sold/distributed)___________________________________________________
Age of Camper: _________Grade Entering Fall 2012: _________
How did you hear about our camp? ________________________
Position Played: _____ Goalkeeper ______ Field
Camp Session: June 25-29, 2012
Camp Times: 9 a.m. – 12 p.m.
Camp Location: XL Soccer World
Applying For a Team Discount/Sibling Discount: If you are Applying for a Team Discount with 6 or more players, please list the team name, team contact, and team contact’s phone number. The discount will be applied AFTER we verify that you qualify for the discount.
Are you ordering a camp ball for $25?
_____Yes (add $25 to fee of $130 for a total of $155)
_____ No, I will bring my own ball to camp every day
Fill out and Return with Payment
($130 Tuition or $155 for Tuition and Ball)
For more information or to register by phone, please contact:
Kerrigan Soccer Schools - 919/819-8347