2022 Summer Soccer Camp

Picture Upload
Accepted file types: jpg, png, pdf, Max. file size: 128 MB.
Please Provide a Picture of the Player:
Player's Name*
First Last
Date of Birth*
MM slash DD slash YYYY
Field Position*
Gender*
Pricing*
June Camp
- 6-10
- 13-17
- 20-24
- 27- July 1
July Camp
- 5-8 * Only Four Days Camp*
- 11-15
- 18-22 ** High School & College Players Half Day Only**
- 25-29 ** High School & College Players Half Day Only**
Parent / Guardian Name*
First Last
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone*
Email*
Signature
Date
MM slash DD slash YYYY

Medical Release Form
Emergency Contact*
First Last
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.
Signature

Payment Form
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Today’s Date
MM slash DD slash YYYY
Camp June: Week 6 - 10*
Price:
Early bird discount
$0.00
Until March 31st only
Camp June: Week 13 - 17*
Price:
Early bird discount
$0.00
Until March 31st only
Camp June: Week 20 - 24*
Price:
Early bird discount
$0.00
Until March 31st only
Camp June: Week 27 - July 1*
Price:
Early bird discount
$0.00
Until March 31st only
Camp July: Week 5-8*
Price:
Early bird discount
$0.00
Until March 31st only
Camp July: Week 11 - 15*
Price:
Early bird discount
$0.00
Until March 31st only
Camp July: Week 18 - 22*
Price:
Early bird discount
$0.00
Until March 31st only
Camp July: Week 25 - 29*
Price:
Early bird discount
$0.00
Until March 31st only
Training Soccer Camp - Total
$0.00
Full Day $295 per Week
Half Day $195 per Week
Credit Card

American Express
Discover
MasterCard
Visa
Supported Credit Cards: American Express, Discover, MasterCard, Visa
Card Number Expiration Date Security Code Cardholder Name
*
- 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.
Refund Policy*
- If you are needing to cancel a registration, for any reason we will refund you in full all the way up until 14 calendar days prior to the start date of the event. If cancelled 14 days or less prior to the start of the event, you will be refunded 50% of the camp fees. No refunds will be issued after the start of a camp. No refunds will be made for cancellations due to inclement weather, injuries or other circumstances beyond our control.

Step 1 of 3

Medical Release Form

Payment Form