UK International Community Day Camp Application

Complete one application per player. Make check(s) payable to UK International.
Mail with full payment to UK International Soccer Camps, Inc. P.O. Box 1838, Redlands, CA  92373
or fax to: (909) 793-7310. Call office (888) UK SOCCA, or local coordinator for further information.

Players Name:_____________________ Age:_____ Date of Birth:_________________

Parent/Guardian Name:____________________ Player's Sex: M F (circle)


City:___________________________ State:____________ Zip:___________________

Phone: Home (___) _________________ Work (___) ___________________________

E-mail Address: _________________________________________________________

Name of Organization/Team: _______________________________________________

Dates of Camp: ________ Location: _________________________________________

Half Day Full Day Time of Session:___________________________________
Check appropriate boxes:Fun in the Sun (4-6yrs.)Skills'n'Thrills (7-10yrs.)
Compete With your Feet (11yrs.+) Team (If available) GK (If available) Strikers (If available)
Camp Cost: $ ________ Family Discount ($5 for 2nd, 3rd, etc. sibling)
Shirt Size: YM(10-12)YL(14-16)AS(34-36)AM(38-40) AL(42-44) AXL(46-48)
GK Clinic $30 (optional) Strikers Clinic $30 (optional) Ball $15 (optional) Water Bottle $5 (optional)
Shinguard $10 (optional) XXS (5-6 yrs) XS (7-8 yrs) S (9-12 yrs) M (13-16 yrs)
Total Cost $ _____ Payment: $________   Cash  Check CK#_____ Credit Card
Credit Card (check one)  Visa     MasterCard    Discover
#_________________________________________ Credit Card Exp. Date (mo/yr): _______

Credit Card Verification(3 digits) #:_______ Signature: ______________________

YES, I want more information on: Hosting a coach Residential programsUK Camp in the UK
How did you hear about us? _________________________________________

I Certify that my child enrolled above is in excellent health and may participate in strenuous physical activities including soccer. I agree to defend and hold UK International Soccer Camps, its servants, agents, and/or employees and contractors harmless from any and all claims for injuries sustained by my child during his or her participation in the camp. Permission is hereby granted to UK International Soccer Camps, to use pictures and any video footage of the campers in any promotional materials. Permission is granted for my child to receive emergency medical treatment, if needed, and I certify that there are no limits to my child's participation except as stated in writing and included with this application. Refunds can be given at the discretion of UK International depending on the nature of the situation. Children who leave during the program due to injury or illness will receive a pro rata refund. A $15 handling fee will be required on any refund, no refund will be given for cancellation within 7 days of the camp start date. Children are enrolled on a fist come first served basis. We cannot guarantee enrollment any later than 5 days prior to camp. Should inclement weather affect the program, any lost hours will be made up later in the camp week. If this is not possible, refunds will not be issued.

Signature of Parent/Guardian...................................................................... Date.................................

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