Location: Palm Bay Regional Park
Dates: July 18th to 21st
Time: 9:00am to 12:00pm and 9-4:00pm
Who: Boys & Girls 5-16
Cost: $40.00 Half Day and $85 Full Day (Lunch included for full day campers only )
SSTI AND PALM BAY YOUTH SOCCER
Presents:
SUMMER SOCCER CAMP 2011
CAMPER INFORMATION
Date of Birth:
 Gender:
First:
Last:
Street Address:
 State:
 Zip Code:
City
Emergency Contact
Person:
Cell Number:
Home Phone Number:
PARENT/LEGAL GUARDIAN INFORMATION
Cell Number:
Name:
 E-mail Address:
Have these forms filled out before registration on Monday so we can start promptly
PRINT HARD APPLICATION HERE
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