WINNING GOAL SOCCER CAMP 2008

( For Teams & Individuals)

Camp Begins - Monday, July 7 @ 8 AM

Location: Trinity High School Soccer Field

Camp Dates: Monday, July 7 thru Thursday, July 10

Camp Rates: Individual - 8 am until 12 Noon $110

Family - 8 am until 12 Noon $ 110 ($10 less for each additional)

Team - 8 am until 12 Noon $100 (8 or more)

Campers can be dropped off @ 7:00 AM

Camp Begins @ 8:00 AM

Camp Ends @ 12 Noon

Campers Will Receive: Soccer Ball, T-Shirt and Bag

Campers Need to Bring: Soccer Shoes, Shinguards, Extra Socks, Clothes if needed, and Sun Screen

(Please Label All Personal Items)

Snacks: Light Snacks provided, campers may bring additional snacks

(Please No Glass Containers)

Drinks: Available for $1.00

ALL COACHES ARE INVITED TO ATTEND TO LEARN NEW SKILLS AND DRILLS FOR YOUR TEAM.

The philosophy of the camp is to train and teach players to reach their potential and enhance understanding of the game.

Players Will Leave With A Great Soccer Experience!

Applicant's Name__________________________________

Tee Shirt Size: YS YM YL AS AM AL AXL (circle one)

Age____ Today's Date__________Gender________

Team's Name____________________________________

Coache's Name__________________________________

Parent or Guardian Signature________________________

Contact Phone Number____________________________

Emergency Phone Number_________________________

CCN___________________________________________ Card Type_________Exp Date______________________

Checks Payable to: WGSC

Mail To: Winning Goal Soccer Camp, 6611 Fairview Church Road, Trinity, NC 27370

For more information please contact Mike Sink @ (336-434-5314) or (336-687-3304)

Fax To: 336-434-5310

I the undersigned hereby certifies to be the parent or legal guardian of_________________________________, and certifies that my child is physically fit, mentally capable and medically qualified to participate in the Winning Goal Soccer Camp activities. I understand that soccer is an active physical sport ant that injuries can occur. I understand that every effort will be made to contact me in case of an emergeancy concerning my child, however, if I cannot be reached and/or if time is of essence, I hereby give my permission for Winning Goal Soccer Camp Staff to seek appropriate medical attention for my child, for medical attention to be given and received by my child in the event of accident, illness, or injury during the period of the camp. I will be responsible for any and all cost of medical attention and treatment. I, the undersigned, for myself and my heirs, executors and administrators, waive and release, and forever discharge Winning Goal Soccer Camp, its Officers, Coaches, High School Players, Trinity High School, Trinity High School Administrators, Randolph County Board of Education and/or Administrators or any Volunteers are released from any and all liabilities in connection with medical treatment and any accidents or injuries which may occur during or after the Winning Goal Soccer Camp.

Name of Child's Insurance Company____________________________________

Policy Number________________________________

Policy Holder_________________________________

Parent or Guardian Signature____________________________________