Francis Okaroh's  Ultimate Soccer Academy Registration Application 2008

Name:________________________________________

Address:______________________________________

City:_____________________STATE:_________ZIP:__________ COUNTRY:_________

Phone Number:________________________E-Mail:______________________________

Age: _______  Gender:_____________   Current Grade in School: ____________ (Must be at least 10yrs old as of July 1st, 2008)

Parent's Name(s):__________________________________________________________________________

Parent's Daytime Phone Numbers:________________________________________________________
 
T-Shirt Size (Adult Sizes):  (circle one) Small   Medium  Large   X-Large

Shorts Size (Adult Sizes):  (circle one)   Small   Medium  Large   X-Large

Please Circle the Appropriate

Shirt & Shorts Size

 
T-Shirt Size (Youth Sizes):  (circle one) Small   Medium  Large   X-Large

Shorts Size (Youth  Sizes):  (circle one)   Small   Medium  Large   X-Large

Check Box Below

Indicate the week(s) of camp you wish to attend:            "Watch Final Match on Check Out Day @ 1:30pm"

 

Session 1: July 6 - July 11, 2008 -Individuals & Teams (Sun - Fri)    Check In: Noon/Sun Check Out: 4:00pm/Fri 

 

Session 2: July 27 - August 1, 2008 -Individuals & Teams (Sun - Fri)    Check In: Noon/Sun Check Out: 4:00pm/Fri 

 

Session 3: August 3 - 8, 2008 - Individuals & Teams (Sun - Fri)           Check In: Noon/Sun Check Out: 4:00pm/Fri  

     

Rate Pay by:     May 1st, 08

Jul 1st, 08

Day of Camp

Check Box Below

Individuals please check one of the following: 

 

 

 

$650 (Includes 3 meals)  Overnight Camper- 1 week

$675

$700

 

$550 (Includes 2 meals)  Day Camper  - 1 week

$575

$600

         

Team members please check here and enter team name (click here for more Team Week Info):

 

$600 by May 1st (Includes 3 meals) Team Player  - 1 week -{ $625 by Jul 1st}, {$650 Day of Camp}

Enter Team Name:

 

Check Box Below

Two Week Discount - Campers who wish to attend two weeks: 

  

$1120 May 1st, 07 (Includes 3 meals)  Overnight Camper-  - 2 weeks { $1170 by Jul 1st}, {$1220 Day of Camp}

 

$1020 May 1st, 07 (Includes 2 meals)  Day Camper           - 2 weeks { $1070 by Jul 1st}, {$1120 Day of Camp}

     
A nonrefundable deposit of $250 is required with your application for each registered camper.
Registrations are accepted on a first come, first serve basis.
Balance of payment is due by July 6, 2008, and is nonrefundable.
Mail Registration forms and Make Checks Payable to:  Francis Okaroh,
23 Paquin Drive, Marlborough, MA 01752