2005 REGISTRATION FORM

I would like to enroll in the 2005 “Hawk” Soccer Camp. I hereby waive, release, and forever discharge all staff members of any liability or claims arising out of any loss, personal injury, or property damage that may occur during participation in this camp.  In case of an emergency I grant permission for my son/daughter to be given emergency treatment at a local hospital.

  Player’s Name: ______________________________               Age: ____  Gender:  ______

  Parent’s Name: ______________________       

  T-Shirt Size (Circle):  YS     YM     YL     AS     AM     AL     AXL

  Address: ___________________________    City: _____    Zip: __________

  Home Phone: ______________      Work Phone: _______________

  School Attending (Fall ‘05): ______________     Grade (Fall ’05): _______

  Emergency Contact Person: _____________________       Phone: __________

  Parent/Guardian Signature: __________________________

Questions/Concerns about "HAWK" Soccer Camps should be directed to Coach Staus   kjstaus@nconnect.net

Campers may attend the “Hawk” Soccer Camp and 
“Hawk” Specialty Camp for a discounted rate of $115.  

SIGN UP FOR

DATE

PRICE

CHECK CAMP

Hawk Soccer Camp
   Girls (9-11:30 am) or Boys (12:30-3:00 pm)

7/18-7/21

$75.00

  

Hawk Specialty Camp 
 (9:00-11:00 am)

7/11-7/13

$50.00

  

Hawk Finishing Camp
(9:00-11:00 am)
Limited Enrollment of 40 campers!

6/13 - 6/15

$50.00

  

Pre-Season Conditioning Camp
Jeff and Randy Staus  (AHS and PHS)
Only open to High School Players - BOYS

8/8-8/11
(6:00-8:00 pm)

$55.00

 

HIGH SCHOOL Girls TEAM CAMP
Jeff and Randy Staus  (AHS and PHS)
Only open to High School Players - GIRLS

8/1-8/4
(6:00-8:00 pm)

$55.00

 
   

     TOTAL:   

  

Circle desired camps and send check made payable to “JEFF STAUS” to:

Coach Staus
715 Harrison Ave
Hartford, WI 53027

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