Soccer Player Information

First Name	Initial
Last Name	Age
	Male Female
Street Address & City/State/Zip

Parents/Guardian

Name
Street Address & City/State/Zip
E-mail Address
Home Phone
Work Phone
Cell Phone

Moravek Soccer Summer Academy Programs

	Ages 6–12	9:00 am–3:30 pm each day
	Ages 6–12	9:00 am–12:00 pm each day
	Ages 3–5	9:00 am–10:30 am each day
June 21–25 Purcellville, Franklin Park
June 28–July 2 Purcellville, Franklin Park
July 5–9 Off
July 12–16 Sterling, Claude Moore Park
July 19–23 Ashburn, Ashburn Elementary School
July 26–30 Ashburn, Ashburn Elementary School
August 2–6 Ashburn, Ashburn Elementary School
August 9–13 Leesburg, Leesburg Annex
August 16–20 Leesburg, Leesburg Annex
August 23–27 Purcellville, Franklin Park
After registering, participants will NOT receive confirmation of enrollment unless requested.
2010 Residential Camp Dates
Premier Advanced Camp July 25-29: Boys Ages 9–18 Frostburg State University, Frostburg, Maryland Premier Advanced Camp August 1-5: Boys Ages 9–18 Frostburg State University, Frostburg, Maryland Premier Advanced School: $525.00 per student Siblings: $485.00 per student, Two week participants $485.00 per student Team with 10 or more: $485.00 per student
Roommate Request — Residential Camp   MORAVEK SOCCER RESIDENTIAL HEALTH FORM MUST BE COMPLETED IN FULL AND BROUGHT ON THE FIRST DAY OF CAMP. PLEASE CLICK TO DOWNLOAD FORM. A $100.00 is deposit required with your application. The balance is due on first day of camp. No refunds give after registration. Every student must get a full physical before attending camp and provide it to the staff on the first day of registration.
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