CIU Boys and Girls S.O.A. R Soccer Camp Registration
Date and Times: July 25 - July 28 | 9:00 am - 12:00 pm
Cost: $100
Ages: 5 - 14
Contact: James Whitaker | 803.807.5247 | jwhitaker@ciu.edu
Parent Name (first and last):
Email:
Phone Number:
Alternate Phone Number:
BLS or CIU Faculty or Staff?
Mailing Address
Address:
City:
State:
Zip:
Campers
Camper Name (first and last):
Age:
Gender:
T-Shirt Size:
Please list any allergies or medications:
Address (if different from above):
The following campers will be registered:
Insurance Company and Policy Number:
Camp Release/Waiver:
Click here to print and sign the waiver. Every camper must have a signed waiver prior to participating in camp.
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Payment Amount: