5206 N Midland Drive

5206 N Midland Drive

Midland, Texas 79707

(432) 699-6068

Email: fccmidland@sbcglobal.net

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Soccer Camp Online Registration for 2010 - The Proven Method

Soccer Camp registration is $40! Each participant will get a custom jersey and a ball. Please submit your payment before the first day of camp. Scholarships are available! For those entering two or more kids, you can get a deal, ($40 for first, $35 for second, $30 for third and so on) children must be part of the family unit to take advantage of this deal.

DIRECTIONS: Please fill out the form as completely as possible. Use the TAB key to move to the next data field. When you are done filling out all the data fields, click the Submit button at the bottom of the form to submit it. After you click Submit, you will receive a confirmation page. Please print the confirmation page and give it to the registration leader when you arrive at Soccer Camp.

Soccer Camp Participant's Personal Information

First Name
Last Name
Primary Address
City
State
Zip Code
Home Telephone	432-123-4567
Cellular Telephone	432-123-4567
Parent's Email Address
Date of Birth	mm/dd/yyyy
Church
School
Grade Child Will Enter in the Fall
List any special needs or disabilities you want us to know about.
List any allergies we should know about. (peanuts, bee stings...)
Father's Name
Mother's Name

Soccer Camp Participant's Emergency Contact Information Please provide someone that can be reached and respond while this child is at Soccer Camp.

First Name
Last Name
Relationship
Telephone	432-123-4567

Soccer Camp Jersey Please select your child's Jersey size.


Payments can be mailed to, or dropped off at: Fellowship Community Church 5206 N Midland Dr. Midland, TX 79707

Soccer Camp Scholarship Request

Request review for a Soccer Camp Scholarship

Please click Submit after completing and reviewing your registration.