ALL AMERICA LACROSSE CAMP
BOY'S REGISTRATION FORM
FEE: $500/week

The camp is open to young men ages 9-17.  A $200.00 deposit must accompany each registration form.  The balance of the camp fee ($300) is due at registration on the first day of camp.  The fee for day campers is $425.  Mail form along with a check or money order, made payable to ALL AMERICA LACROSSE CAMP, to:  ALL AMERICA LACROSSE CAMP, P.O. Box 157, FRUITLAND, MARYLAND  21826.   NOTE:  No Refunds for Withdrawals after June 16, 2008.
 

WEEK:     Thursday June 26 - Sunday June 29, 2008 

Name:   Birth Date:

Street Address: City: State:    Zip Code:

Age on 7/1:     HT:     WT:lbs.
 
Shirt Size:  Adult S/M    Adult L/XL  
 
Position (One Only):  Attack    Midfield    Defense    Goal    Don't Know 
 
Roommate (ABSOLUTELY  No Triples):
I HEREBY REQUEST THAT MY CHILD NAMED ABOVE BE ADMITTED TO THE ALL AMERICA LACROSSE CAMP, AND AUTHORIZE THE DIRECTORS TO ACT FOR ME ACCORDING TO THEIR BEST JUDGMENT IN ANY EMERGENCY REQUIRING MEDICAL ATTENTION.
 
Parent Signature:                                                                           Date:                                
 
Home Phone:   Parent's Work Phone:    
 
Insurance Company:   Policy #
 
E-mail Address:
 
Credit Card Information    
Visa      Master Card        AmEx           Discover
Name on Card    (Please Type or Print)  
Card Number                      Exp. Date     
 
     Check Here if you want your confirmation via e-mail
 

CAMP USE ONLY:   Date Rec: _______ Amt: ______ CL: _______ Due: _______  Cash/CK#: ____________ Room: ____________
 
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