Full-Day SUMMER SOCCER FUN

Ages: 5-thru-13
Fee: $185 a week (Half Day $90)

Drills & Scrimmages at Takoma Park Middle (9:00 a.m. – 3:30 p.m.)
Chief instructor – the popular Adrian Baez, varsity coach at Blair

Director -- Howard Kohn

Have Fun & Learn Soccer!!!!

July 21 - thru – July 25
and /or
July 28 -thru- August 1


(Limit of 95 players: First come, first served. Each player will be sent a letter with a full list of information.
For questions contact Howard Kohn at kohn@erols.com.)
Player’s Name   Birth:    Grade    Gender

Names of Parents

Address

Phone (home) (work)

E-mail address (important!)

Name & Number of Emergency Contact (during camp week):

Medical Needs or Other Special Information:

Did you also register separately for the TP Rec. Dept. before-care or after-care? before-care after-care neither

I hereby give my child permission to participate in this soccer program. I understand that no accident insurance is provided, and I agree that I will not hold TPNYS or the Takoma Park Recreation Department responsible for any injury sustained while participating in this program.

Signature of Parent or Guardian ______________________________________________

Fee: $185/week (Write checks to Takoma Park Soccer or TPNYS)
Mail to: TPNYS, 16 Jefferson Ave., Takoma Park, Md. 20912


NOTE: We need an original signature on the form.