Lighthouse Point Academy

2020-2021 Season

AGE GROUP – U7 (2012) – U13 (2007)
SEASON – August 13th – May 27th
DATE/TIME – Tuesday and Thursday (6:00 P.M. – 7:30 P.M.)
LOCATION – Frank McDonough Park 3500 NE 27th Ave, Lighthouse Point, FL, 33064
COST PER PLAYER – $250.00 Registration, $85.00 Uniform Fee
UNIFORM INCLUDES – 2 uniforms jerseys, 1 pair of shorts, 1 pair of socks and 2 training shirts.
MONTHLY PRACTICE FEES – $110.00 Coaching and Training Fees.
COMPETITION FEES – 2 leagues (Fall League and Winter League) Referee Fees, and US Club Player pass for 2019/2020 Season.
FOR PURCHASING UNIFORMS VISIT – Destination Athlete

Picture Upload
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Please Provide a Picture of the Player:
Player's Name*
First Last
Date of Birth*
Date Format: MM slash DD slash YYYY
Gender*
Parent / Guardian Name*
First Last
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone*
Email*
Age Group
Jersey Number*
Signature
Date
Date Format: MM slash DD slash YYYY

Medical Release Form
Emergency Contact*
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Phone*
Allergies*
Medical Conditions*
Physician's Name*
First Last
Physician's Phone*
Medical Insurance Providers*
Insurance Policy Holder's Name*
Policy Number*
Insurance Provider Phone Number*
Saint Andrew's School and Camp maintain privacy over your child's health information. In accordance with this policy, access to all health information is limited to the nurse, counselors and administrators and is only utilized for the safety and protection of your child or in an emergency.
The parents consent to medical treatment by the camp nurse as needed as well as transportation to the closest hospital in the event of an emergency by ambulance. All efforts will be made to contact the parents in the event of an emergency.
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Registration Fee
Please Choose Developmental or Competitive Program
Payment Form
Training Fee
Price: $110.00
Please Note $110 Fee per Month
Practice Twice a Week ( Tues & Thurs) Optional Extra Training in Our Location in Boca Raton Mon & Wed.
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- Upon checking this box, you will be providing Colo Colo Soccer Academy USA with valid and updated credit card information. If you provide your credit card information to Us, You authorize Us to charge such credit card for all Purchased Services, including Registration Fees, or Ongoing Training Fees. Early termination from Training Fees requires a written notice to colocolosoccerusa@gmail.com 30 Days in Advance.