Max Indoor Camp Registration

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Simply the Best Training There is

Camper # 1

at Pleasant Dale March 29, 30, 31 and April 1st

STP Pleasant Dale Spring Break Camp Registration Form

Session AAll Skills Boys/ Girls U8 - U10 9:00 - 11:00am $ 90

Session BIntermediate Skills Boys/ GirlsU11 - U149:00 - 11:30 am$ 105

Camper # 2

Emergency Contact If Parent / Guardian cannot be reached

Emergency Contact Name *

Home Phone *

Cell

Medical Conditions Required Na if none

Physician Name

Insurance Co.

Phone

Holders Name

Policy #

Group #

Click here to see Authorization Form

I acknowledge that I have read and accept the terms of the Authorization for Emergency Medical Treatment and Liability Wavier and I am a Parent and / or Legal Guardian for the Child or Children listed on this form

Select Session

First Name *

Last Name *

Age *

Current Team

Name

Home Phone *

Cell Phone

Email Address

Father

Physician Phone

Every Participant Receives a Free STP T-Shirt