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INDIANA WOMEN'S SOCCER CAMPS

December 15-16, 2012, Bloomington, Indiana
Mellencamp Pavilion on IU campus

CAMP COSTS

$225.00 Individual Rate 

CAMP DETAILS

- Players will train with collegiate coaches on the beautiful IU campus

- Players trained in a collegiate environment over the weekend

- Ages from 8th grade and up

- ACCOMODATIONS AND MEALS ARE NOT PROVIDED FOR THIS CAMP (for information on hotels, visit bloomington.com)

- Coaches from IU, Evansville, Southern Indiana, E. Kentucky, N. Kentucky, IUPUI and Lamar (TX) have committed to attend

FACILITY and DIRECTIONS


We will use the John Mellencamp Pavilion. Mellencamp is just south of 45/46 and is located in the same area as Memorial Stadium and Assembly Hall.  


FOR REGISTRATION INFORMATION:

Phone: 1-812-856-1481

E-Mail: Click Here!
Register On-Line: Now Available!

All IU Camps are open to all and any entrants

2012 College Prospect Camp


Registration Note: Registrations will be accepted until the camp is full. All registrations must be accompanied by a non-refundable $225 deposit.
If you have questions, please call 812-855-9448.

Please complete the form below and submit camp payment.
 
Camper's Name (Last, First)*
 
Home Address*
 
City*
 
State*
 
Zip*
 
Graduation Year*
 
Club Team
 
Parent's E-Mail Address*
 
Age*
 
Birthdate (Month/Day/Year)*
 
Position*
 
T-Shirt Size (adult sizes)*
 S
 M
 L
 XL
 XXL
 
High School*
 
HS Coach's Name
 
HS Coach's Phone
 
Club Coach's Name
 
PARENTAL CONSENT FORM  
Camper's Name (Last, First)*
 
Allergic Reactions
 
Present Medication (include dosage)
 
Date of Last Tetanus Toxoid
 
Past illness that would be useful if treatment is nessessary
 
IN CASE OF EMERGENCY  
Emergency Contact (Name, Relationship)*
 
Home Phone #*
 
Cell Phone #*
 
Work Phone #
 
Physician's Name
 
Physician's Phone #
 
INSURANCE INFORMATION (All campers must carry their own insurance)  

Insurance Company*
 
Name of policy holder*
 
Policy Number/Group #*
 

* Medical/Legal Waiver: I hereby certify the Indiana W- Soccer Camp staff has the full and unconditional authority to proceed with the diagnosis and treatment as judgment indicates for injuries during camp. The Indiana W- Soccer Camp and Indiana University shall not be held responsible for any consequence resulting from such injuries. I sign voluntarily with full knowledge of its significance.  

Parent/Guardian Name*
 
Date*
 


PAYMENT OPTIONS
Please select your payment option by indicating a '1' in the quantity field. We need a registration form and consents completed for each participant.

Note: A charge from Hoosiersportscamps.com will appear on your credit card for your on-line registration. However, if any of the IU Women's Soccer Camps are canceled for any reason, refunds must be collected directly from IU Women's Soccer Camps, Inc., PO Box 5073, Bloomington, IN 47407. Phone 812-855-9448.
 
Qty 
 $225.00 Individual Registration - Payment in Full