Print out application for use.

Name: __________________________________________________

Address: ________________________________________________

City/State/Zip: ____________________________________________

Home Phone: _____________________________________________

Emergency Phone: _________________________________________

Parent/Guardian Name: _____________________________________

Date of Birth: _______________

Age: __________

Contact Email Address: _____________________________________

Roommate Preference: ______________________________________
(Resident campers can request a roommate or will be assigned one.)

Player Information: Select One

Field Player:
Goalkeeper:

Discounts

* Team/Group Name:
A $25 discount per person is available for teams or groups of 10 or more campers. (All applications must be sent in together in order to receive discount!)
* Family: A $25 discount is available for additional family members who attend!
* Vanderbilt University Faculty or Staff Member:
A $25 discount per person is available for the daughter of a VU faculty or staff member!

Deposits

Day Camp: A $50 non-refundable deposit must accompany your application to reserve your space for for the Day Camp. Residential or Elite Camp: A $100 non-refundable deposit must accompany your application to reserve your space for the Residential or Elite Camp.

Please Check Camp of Your Choice
Half Day Camp: June 2-6; $125 (Ages 5-13)
Half Day Camp: June 16-20; $125 (Ages 10-17)
Day Camp: June 2-6; $200 (Ages 5-13)
Day Camp: June 16-20; $200 (Ages 10-17)
Residential Camp: June 21-25; $450 - Resident (Ages 12-18)
Residential Camp: June 21-25; $350 - Commuter (Ages 12-18)
Elite Camp: June 21-25; $500 - Resident (Ages 13-18)
NETperformance Goalkeeping Academy: June 21-25; $525 (Ages 13-18)

Ball: Please check one!
* I will bring my own ball _____
* I will purchase a hand-stitched ball for $25 _____
* I would like a size 4 ball _____ (Size recommended for players who are under 12 years old)
* I would like a size 5 ball _____ (Size recommended for players who are over 12 years old)

T-Shirt Size: Please check one!
*Youth _____ (small _____, medium _____, large _____)
* Adult _____ (small _____, medium _____, large _____)

Airport Shuttle Service: Please check if you need shuttle service form the airport!
* I will need shuttle service ($20 fee) _____
Arrival Date & Time: ________ Airline: __________ Flight #: ________ Departure Date & Time: ________ Airline: __________ Flight #: ________

Return completed application form and camp tuition (payable to Vanderbilt Soccer School for Girls) to:

Vanderbilt Women's Soccer
Dept. AT 40459
Atlanta, GA 31192-0459
(Vanderbilt finances through a bank in Atlanta, GA)

Any questions regarding the Vanderbilt Soccer School for Girls, please contact:

Ronnie Hill (Vanderbilt Soccer School for Girls Director) or Jarett Smith (Camp Coordinator)
Phone: (615) 343-8099 or (615) 343-8095
Email: ronnie.hill@vanderbilt.edu or jarett.smith@vanderbilt.edu

Release From Liability
Vanderbilt Soccer School for Girls

Vanderbilt University will be sponsoring the Vanderbilt Soccer School for Girls camp, a summer day camp on campus in Nashville, Tenn. At the camp, players will be participating in soccer skill activities and games.
I would like for my child, _________________________, who is _____ years of age, to participate in the Vanderbilt Soccer School for Girls camp and I consent to such participation.
I recognize and understand that I am allowing my child to participate in this camp voluntarily, that the camp is optional and that my child may be exposed to some level of riske of injury during camp.
Futhermore, in consideration of Vanderbilt University allowing my child to participate in this camp, I hereby do release and hold harmless Vanderbilt and its trustees, agents, officers, servants and employees against loss (including reasonable attorneys' fees) from any and all claims, or causes of action of any kind or nature that may be brought by or on behalf of me or my child arising out of any and all known or unknown, foreseen and unforeseen bodily or personal injuries, damages to property and consequences thereof which may be sustained by me arising out of or in connection with my child's participation in this camp, except such liability or claim of liability as may result from gross negligence on the part of Vanderbilt University.
I have read the foregoing release and understand that I am signing a complete release and bar to any claims as defined above.

__________ ______________________________
Date Signature

______________________________
Witness