2024 Country School Sports CampSoccer Form for Country School Sports Camp

TCS SPORTS CAMP

MADISON

RACQUET & SWIM CLUB

SOCCER FORM

Please note that the cutoff for registering is Friday night for a session that begins the following Monday.

Please Check the Desired Sport and sessions you would like to sign-up for. There will be no classes held on the 4th of July during session 3. In the case of bad weather all classes will be moved to the Gym.

Sessions: (Please select each session your child will attend)

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Parent's First Name: Enter Text

Parent's Last Name: Enter Text

Pick Up Name: Enter Text

Address: Enter Text

Town: Enter Text

Zip: Enter Text

Home Phone: Enter Text

Work Phone: Enter Text

Cell Phone: Enter Text

Child's First Name: Enter Text

Child's Last Name: Enter Text

Date of Birth: Enter Text

Age: Enter Text

Grade: Enter Text

Gender:

Male

Female

Medical Condition:
(if yes, plese fill out form)

Yes

Session 3: 8/7 - 8/11

(Please select all that apply)

Early Drop Off (8am - 9am) $25

Full Day: (9am - 4pm) $210

Late Pickup (4pm - 6pm) $25

Payment Information

Credit Card

Check

Credit Card Type

Credit Card #

Expiration Date:

Final Amount:

Emergency Contact: Enter Text

Emergency Phone: Enter Text

Session 1: 6/26 - 6/30 (ages 5 to 12)

Session 2: 7/17 - 7/21 (ages 5 to 12)

CVV Number: Enter Text

Please select type of camp:

Victory Soccer Sports Camp

Email: Enter Text

Promo Code: Enter Text

Half Day: (9am - 12pm) $165

NEW! Swimming (12pm - 2pm) (MRSC) $90

Image Verification:

I grant permission for my child to be in a photograph for use on the website and marketing materials:

Yes

Additional Information

Please fill out all of the mandatory State forms. A deposit of 25% of the program fee is required to register and hold a place in each session. Full amount of the weekly program fee is due 2 weeks prior to the start of each weekly ses-

sion. Payments are refundable minus a cancellation fee of 10% of the cost of the pro- gram for cancellations 2 weeks prior to the session start date. If you checked the box Medical Condition, please fill out the medical form. please check the weeks you would like to sign up for.

Please call Janelle if you have any questions so we can assist you. (203) 245-9444 / info@tcsscamp.com

Make Checks Payable to Madison Racquet & Swim Club.

Mail Form to: Madison Racquet & Swim Club P.O. Box 508 Madison, CT 06443

Phone: 203.245.9444

Email: info@tcsscamp.com

10% discount on 3 or more weeks, includes siblings if booked separately, discount not retroactive on first two weeks. Please sign up at least a week ahead of time so we can staff the camp. New for this year our Sports Camp will be offered from 9:00-4:00 with an 8:00-9:00 drop off