Roomiany’s Soccer Camp

July28 to July 31                   Competitive Camp

 

Instructors:     

·         Jamshid Roomiany – Pocatello

·         And other local coaches  

Age:     5^{th _  12th} Grade

Time:      6:00 – 8:00 P.M . on Thursday two sessions one in the morning one in the afternoo

Cost:    Pre-registration $50.00 –   Mail to: 191 S. 16^th Place, Pocatello ID 83201

On-site registration $55.00 – 5:30 P.M. on the first day at the field, registration forms @ Century High and Soccer Rockers.

            *Make checks payable to Roomiany’s Soccer Camp*

Where:  Century High School

Questions:       Call Jamshid Roomiany at 232-8741 or soccer rockers 233-5425

First Day:         Bring: 1) A Ball  2) Water  3) And be ready to Work!

* Participants will be placed in age and skill appropriate groups with focus on ball handling, shooting, and dribbling.*

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Roomiany’s Soccer Camp Registration

 

_______________________________    ______   ______________________________

                       Player’s Name                                      Age                                    Date of Birth

 

Sex:    M   /   F     School: ________________________________________ Grade: _______

Parents: _______________________________________________________
Address: _______________________________________________________

City, State, Zip Code: ____________________________________________

 

Family Doctor: _________________________________    Phone: __________________

Medical History and/or Allergies: _________________________________________________

______________________________________________________________________________

Insurance Provider: _____________________________ Policy Number: _________________

 

                I verify that my child has been checked by a licensed physician and is physically able to participate in Roomiany’s Soccer Camp. I here by authorize the camp staff, directors and sponsors to act for me according to their best judgment

                I agree to hold harmless the camp, its staff, directors, and sponsors of any and all liability, action, claims, and demands of every kind and nature whatsoever, which may arise in connection with or resulting from my child participating in any of the camps activities.

 

Signature of Parent or Guardian: _________________________________Date:_____________