Soccer Camp Registration Form

Registration price depends on which camp you have chosen, please apply accordingly. Checks should be made out to Bluffton University and designated for "Soccer Camp." Each participant will receive a ball and camp t-shirt. Late registrants will be accepted, but there is no guarantee of a camp ball and/or t-shirt. Multiple Camp Discount: $10 off registration for attending more than one camp!

Same Household Discount: $5 off registration for each added camper.

Please indicate camp(s) attending:

June July August

Coaching Staff

Player name:
Age: Birth date: Address:

/ /

Phone:
Parent(s) or guardian:

E-mail: T-Shirt size:

 YS (6-8)  YM (10-12)  YL (14-16)

 Adult Small  Adult Medium  Adult Large  Adult XL

Bluffton University Soccer Camp

Camp Dates

Grade level is determined by placement in fall 2012 6-8 Grade Camp: June 4-8

Time: 5:30– 8:00 PM Price: $100

Registration Deadline: May 31 Youth (K-6 Grade) Camp: July 8-12

Time: 6:00-8:30 PM Price: $60

Registration Deadline: July 1

Replaces the "Grace Mennonite Soccer Camp" which has ceased operations.

Youth (K-6 Grade) Camp: August 15-17

Time: 6:00 – 8:30 PM Price: $30

Registration Deadline: August 3

Waiver and Release of All Claims 2012

Assumption of Risk and Agreement to Participate: As a participant in the activities or programs of the Bluffton University Soccer Camp, I recognize and acknowledge that there are certain risks of physical injury and I agree to assume the full risk of any injuries, including death, damages or loss which I or my child may sustain as a result of participation or use of such facilities, activities or programs. I agree to look to my private physician for medical advice and care and to notify instructors of any physical limitation I or my child may have or modifications needed. As a participant, I or my child agree(s) to adhere to rules of the facility and instructional staff or agents.

Waive, Release & Indemnify: I hereby waive, release and discharge any and all claims I may have or may acquire against Bluffton University, its officers, agents, servants and employees as a result of my or my child's participation in the activities and programs of the Bluffton University Soccer Camp and I agree to indemnify and hold harmless Bluffton University, its officers, agents, servants and employees from any and all claims resulting from injuries, damages, and losses, including death, sustained while I or my child are participating in the Bluffton University Soccer Camp, except for willful and wanton misconduct by Bluffton University or its authorized personnel.

I have read and fully understand the above Waiver and Release of All Claims form.

Signature of participant or guardian (if under 18 yrs)

Date

Mail to: Bluffton University Soccer, 1 University Drive, Bluffton, OH 45817