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2008

Registration

Ole Miss Soccer Camp On-Line Registration
Camper's Name (First Last)
Age
Birthdate
Date 08-27-2008
Street Address1
Street Address2
City
State
Zip Code
Grade (Next Year)
School
Parent(s) Name
Parent's Home Phone 10-digits including your area code
Parent's Cell Phone
Parent's E-mail Address
 

Camp Information

Camp 1 - June 8 - 12

Camp 2 - July 13-17

High School Team Camp - July 19-22

Co-Ed Day Camp - July 27 - July 30


Resident [Pricing] Commuter [Pricing] 

Overnight Roommate Request (optional, list one):


Team Name (for Team Camp):

Player Position
Goalkeeper Defender Midfielder Forward


For all registrations you must download and complete the Medical Release Form [required] and either mail it with your check, fax it to us, or bring it to registration.

Payment Type:

Mail Check   [Mailing address] Credit Card

Credit Card Information  [if applicable]

MasterCard Visa

Credit Card Number: Expiration Date(MMYY):

Name on Card:

Amount Paid: $

I authorize UM Soccer Camp to charge my credit card for the above amount.

*NOTE* : There is a $5.00 charge to process your application with a Credit Card.

 
     





CONDITIONS OF APPLICATION
1.  A $100 NON-REFUNDABLE deposit must accompany each application.  Balance is payable
at or before registration.  Camper may bring balance to the first day of camp in the form
of a personal check or cash.
2.  Parental Release: "I release The University of Mississippi and all its employees from
all claims on account of any injuries which may be sustained while attending the camp, and
I agree to indemnify The University of Mississippi and its employees from any claims which 
may hereafter be presented as a result of any such injuries"

          
3.  Accident Insurance: "Campers are insured while on The University of Mississippi campus.
This is a supplemental policy and covers accidents only.  If a camper is covered under an 
existing health insurance policy, the existing policy must be claimed first.  Camp insurance
will pay any charges not covered by your insurance.  If a camper is without any present
health insurance coverage, the camp insurance will pay 100% of all medical bills associated
with a camp injury.  Please inform camp personnel of any special medical conditions or drug
allergies.  The camp insurance does not include travel to and from the University campus."






As an alternative you may download the camp registration form and either complete it and mail or fax it to us, or call with your information.



You may also download the Medical Release Form.





You will need the free Adobe Acrobat Reader to view or print any of the forms