Registration :: Doug Allison's Soccer Academy [soccercamp.com]

REGISTRATION Step 1 of 3

You may register easily and securely below OR download and mail-in your forms.
Please fill-in all applicable fields. We accept Visa or Mastercard.

Select Soccer Camp

Senior Elite
Residential
Team
Full Day
Half Day

Team Attendees (Teams may attend any of our camps)

Team name
Coach name

Soccer Player's Info

Field player/Goalkeeper
First name
Last name
Address
City
State
Zip
Country
Age at camp
Gender
FREE Camp T-Shirt
Diadora Camp Ball
Roommate preference

Parent/Guardian Info

First name
Last name
Home phone
Emergency phone
Email
Insurance company
Policy number
Medical conditions
Parental consent	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

Request shuttle?	Yes (+$20.00) No If yes, please mail or email 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. If we do not receive this information your application will NOT be processed. Please mail or e-mail a copy of your flight itinerary to DASA, Inc or provide it below in the "Additional Info" field.

Additional info

Anything you feel we should know

MAIL-IN 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.

Application Form Parental Consent Form

SECURE PAYMENT

You can process your payment online with confidence. We have partnered with Authorize.Net, a leading payment gateway since 1996, to offer safe and secure credit card and electronic check transactions for our customers.

• 128-bit Secure Sockets Layer (SSL) technology for secure Internet Protocol (IP) transactions.
• Industry leading encryption hardware and software methods and security protocols to protect customer information.
• Compliance with the Payment Card Industry (PCI) Data Security Standard.

For additional information regarding the privacy of your sensitive cardholder data, please read the Authorize.Net Privacy Policy

CONNECT

NEWS

2 World Cup Players Also Played At Furman.
Dreams are inspired on a field during summer camp where pint-sized athletes learn the basics of soccer.
read article » watch video »
Camp Photos on Shutterfly®
2010 Camp photos are up! We've taken advantage of Shutterfly's fantastic features, in turn, giving you more access and options! Visit: http://soccercamp.shutterfly.com

Soccer Camp: Doug Allison's Soccer Academy