REGISTRATION

You may easily register online below OR download and mail in your forms.
Mail-in Registration must be accompanied by a $100 Desposit ($50 Deposit for Half-Day Campers).
For all credit card orders, payment will be processed in full.

DOWNLOAD and MAIL (Must download both forms!) 2008 Application Form 2008 Parental Consent Form

ONLINE REGISTRATION

Select Camp of Choice

Senior Elite Academy: July 6-10; $575.00 Field Player | $625 Goalkeepers

Senior Elite Academy (commuter): $525.00 Field Player | $575 Goalkeepers

Residential Academy: July 6-10 $460.00

Residential Academy (Commuter): $410.00

Team Academy: June 26-June 30 $475.00

Team Academy (Commuter): $425.00

Full Day Academy: July 21-25 $255.00

Half Day Academy: July 21-25 $155.00

Player Type

Field Player	Yes No
Goalkeeper	Yes No

Team Attendees (Teams may attend any of our camps)

Team Name:
Coach Name:

Soccer Player's Info

First Name*
Last Name*
Address*
City*
State*	--------------- Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia 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 Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming
Zip Code*
Age at Camp*
Roommate Preference

Good Stuff

FREE! Camp T-Shirt	Adult Small
	Adult Medium
	Adult Large
	Adult XL
Opt Diadora Camp Ball, $25.00	Camp Ball, Size 4
	Camp Ball, Size 5
	none

Parent's Info

Parent's or Guardian's First Name*
Parent's or Guardian's Last Name*
Home Phone (###-###-####)*
Emergency Phone (###-###-####)*
E-mail*
Insurance Company
Policy Number
Medical Conditions
Parental Consent Terms* Acceptance of these terms will enable health facilities in Greenville and Academy staff to provide prompt care to your minor son or daughter. You may be asked to sign a duplicate of this agreement upon your arrival at camp. I/We, the applicant hereby certify that I (we) am (are) the parent or legal guardian of the camper. I hereby give permission for the staff of the Academy to seek during the period of the Academy appropriate medical attention for the camper and for medical attention to be given and for the camper to receive medical attention in the event of accident, injury, or illness. I will be responsible for any and all costs of medical attention and treatment, except for that covered by the Academy's excess medical coverage policy. I/We, the applicant, understand that soccer is an active, physical sport, and that injuries can take place during play. I/We also understand there will be a number of children attending the Academy, there will be a limited number of coaches and/or counselors, and that our child can not receive individualized attention and supervision all of the time. I/We understand that, as with any sport, injuries can occur, and we hereby acknowledge that our child is physically fit and mentally capable of participating in soccer and Academy activities. I/We, represent that I/We have sought the opinion of our child's pediatrician that Camp Attendee is fully capable of safely engaging in these activities. I/We also understand that it is my/our responsibility in caring for the camper listed above, to be assured that he/she is fully capable of engaging in this sport's activity, and I/we are confident that he/she is able to engage in such sport. I/We, the undersigned for ourselves, our heirs, executors and administrators, waive, release and forever discharge Doug Allison's Soccer Academy, Inc., and its staff, officers, agents, employees, representatives, successors and assign of and from all rights and claims for damages, injury, or loss to person or property which may be sustained or occur during participation in Academy Activities or while at Academy, whether or not damages, injury, or loss is due to negligence. Do Not Agree Agree

Airport Shuttle

Airport Shuttle Required? ($20.00)	Yes No
If yes, please mail or e-mail a copy of your flight itinerary to DASA, Inc. For all applicants living outside of the United States: In order for your registration to be processed, you must provide your flight itinerary information at the time of your application. Please mail or e-mail a copy of your flight itinerary to DASA, Inc. If we do not receive this information your application will NOT be processed.

Additional Info

Anything You Feel We Should Know

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