Register before June 1 and receive your free Pro Kick Soccer Ball
Childs First Name
*
Childs Last Name
*
Address
*
City/ Town
*
Zip Code
*
Childs Age
*
Soccer Club
Telephone Number
*
Daytime Telephone Number
*
Name of Parent or Guardian
*
Insurance Provider and ID#
*
Camp
Select one
June 28- July 2 Full day
June 28- July 2 half day
July 5- July 9 Full Day
July 5- July 9 half Day
July 12- July 16 Full Day
July 12- July 16 half Day
July 26- July 30 Full Day
July 26- July 30 half Day
Aug 2- Aug 6 1/2 Day Camp at Crellin Park
Aug 8- Aug 12 Scholastic Prep evening camp
Free Pro Kick T-Shirt
Youth M
Youth L
Small
Medium
Large
XL
Full Day Camp:
Bethlehem Town Park – Located on Elm Avenue off Route 32 in Bethlehem.
Half Day Camp:
Chatham’s Crellin Park
Evening Camp:
Bethlehem Soccer Plex--9w south from exit 23 left on Wemple Rd.
*= required information
To complete your registration
A non-refundable $50 deposit or payment in full is required with all applications.
Please make all checks payable to: PRO KICK SOCCER and mail to:
Pro-Kick Soccer Camps c/o Jeff Guinn
144 Hasgate Drive
Delmar, New York 12054
Your cancelled check is your confirmation of camp enrollment
