Shore Soccer Camp           
20th ANNIVERSARY

                                                                                        

Official Sponsor and Supplier of Shore Soccer Camp

Camp Registration Form

Please Email the following information to the Shore Soccer Camp Office.

Seits Incorporated
715 Sturbridge Drive
Bryn Mawr, PA 19010
(610) 527-1829

Complete the information below and press "SUBMIT" at bottom of the page
(*Indicates this field MUST be completed)

CAMPER(S) INFORMATION


FIRST CAMPER"S NAME*
MI
LAST NAME*

AGE*
DATE OF BIRTH*
CAMP SESSION*

SECOND CAMPER'S NAME
MI
LAST NAME

AGE
DATE OF BIRTH
CAMP SESSION

THIRD CAMPER'S NAME
MI
LAST NAME

AGE
DATE OF BIRTH
CAMP SESSION
 

PARENT 1 NAME*
PARENT 2 NAME		  

PERMANENT ADDRESS 1*
PERMANENT ADDRESS 2		  

CITY*
STATE*
ZIP CODE*

(AREA CODE) HOME TELEPHONE*
(AREA CODE) CELL PHONE*		  

INSURANCE COMPANY*
POLICY NUMBER*		  

SUMMER ADDRESS		    

CITY
STATE
ZIP CODE

SUMMER TELEPHONE		    

EMAIL ADDRESS		    

How did you learn about Shore Soccer Camp?
Friend Family Website Other

Comments/Questions



Clicking Submit Will Email Your Application
To Shore Soccer Camp. Please mail your payment to the above address.
Payment is also accepted through PayPal to the following address: shoresoccercamp@yahoo.com





Thank You For Your Interest In Shore Soccer Camp

Shore Soccer Camp, 715 Sturbridge Drive, Bryn Mawr, PA 19010 (610) 527-1829

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