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2008
Recreational Camps
TUCKER YOUTH SOCCER
ASSOCIATION
Tiny Tykes / Tykes
Camp Registration Form
Summer 2008
Player
Name____________________________________________
Age___________
Parent/Guardian Name
_______________________________Home Phone______________________
Email (write clearly)
________________________________ Work Phone_______________________
Home
Address______________________________________________________________________
Street
City State Zip Code
Health
Concerns_____________________________________________________________________
Camp
(please check appropriate fee)
TYSA Player NON TYSA Player
Tiny Tykes Camp
( 3 - 4) $65_______ $70_______
Tykes Camp
(5 - 6 ) $90_______ $95_______
July 29 - August 1
(9am - 11am)
PARENTAL PERMISSION AND
WAIVER
I, the
parent/guardian of ____________________________________________, hereby
authorize the employees, representatives and/or designated agents of
TYSA Camp to act for me in their best judgment in any emergency that
requires medical attention for the above named minor. I hereby waive and
release all employees, representatives, and designated agents of TYSA
Camp and the Tucker Youth Soccer Association from any and all liability
for any injuries or illnesses suffered while participating in Soccer
Camp, 2008. It is also understood that TYSA will not be responsible for
any damages caused by said minor or for loss or damage of any personal
items or property. It is understood that I must inform TYSA in writing,
of any special health or medical needs.
Signature of Parent/Guardian:
_____________________________________________ Date: ___________________
Fill
out registration form and mail it in with a check made out to TYSA
to the following Mailing
Address :
Tiny Tykes / Tykes Camp
Nancy Marsden, 256 Lamont Drive,
Decatur, GA
30030
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