22 AM CAMP REGISTRATION

TES GK WORKSHOP - SUMMER 2022
Registration Form

* Indicates required field

Parent or Guardian's Name *

First

Last

Player's Name *

First

Last

Player's Age *

Player's Date of Birth (DD/MM/YYYY) *

Player's Current Club *

Parent or Guardian's Email *

Parent or Guardian's Address *

Line 1

Line 2

City

State

Zip Code

Country

Cell Phone Number *

Home Phone Number *

Player's Gender *

Girl Boy

GoalKeeping TES Camp *

August 15-19, 2022 / 4:30-5:30 / DINIZ Field

Age Group: *

Comments *

Submit

• Please complete the attached waiver and return to philbergen@teamexcelsoccer.com before the first day of camp: