2013 Viking Boys Soccer Camp
Sponsored by Lenexa
Kiwanis Club
When: May
28-May 31, 2013 (Tuesday to Friday) 8:00-11:45am. (Arrive 15 min. early – Bring water) Daily Hotline
993-8070 & 1-252
Where:
SM West Soccer Field park in Antioch parking lot
Who: Any
boy entering grades 9-12 who plans to tryout to play soccer at SM West in the 2013-2014 school year.
What: The coaches and players begin this important off-season time together
emphasizing individual development and team play. Bring indoor, running and outdoor shoes.
Why: This is an excellent way to begin the summer preparing to
play soccer at West.
Cost: $60.00 ($65.00 after Wednesday, May 22)
Cash or make check payable to: Lenexa Kiwanis
Club
(put Viking Boys Soccer camp on Memo line)
Mail to: Lenexa
Kiwanis Club Questions? Gordon Wetmore – Head Coach
P.O. Box 14632
(913) 829-7379 - Home
Lenexa, KS 66215
Home e-mail: noiinteam@att.net
Attention: Dave Baumgartner
Deadline:
Send form/payment as soon as possible and no
later than Wed., 5/22/13.
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Registration Form
~ 2013 Viking Boys Soccer Camp
Name:__________________________________________________________________________________
Address:________________________________________________________________________________
(street)
(City)
(State)
(zip code)
Home Phone: _ _ _ - _ _ _ _
Parent’s work/ cell Phone: _ _
_ - _ _ _ _
(for emergency contact during camp)
CIRCLE one in each category:
Grade in Fall 2013 : 9 10 11 12
T-shirt Size: M L
XL XXL
Pos: GK Def Mid For
The undersigned states the He/She understands that the Viking Boys Soccer Camp and Kiwanis Club of Lenexa are not
and shall not be responsible for or liable for any illness, or injury to person or damage to property resulting from participating
in said program, and the participant and the undersigned, if the participant is a minor or under other legal disability, hereby
forever release and holds harmless the said Viking Boys Soccer Camp, its employees, agents and representatives from any and
all claims of any kind that the participant or the undersigned or their respective heirs, executors, administrators, or assigns
may have or claim to have resulting from participating in said program.
I HAVE READ AND UNDERSTAND THE WAIVER STATEMENT.REGISTRATION IS INVALID WITHOUT
SIGNATURE.
____________________________________________________________________________________________________
Parent
Signature Approval
Date
