Soccer School at Brewster Academy Registration Form

Print this application fill it out, and send it along with full tuition or deposit.

APPLICATION (One per participant) Enrollment Limited – Register Early
For more information call Coach Miller at: 603-934-6713 (phone and fax) or email: brewsteracademysoccerschool@hotmail.com

Enclosed: Full Fee____ or $100 Deposit____

Resident $500____Commuter $250____ Five player group registration 10% discount (Registrations must be turned in at the same time) (See brochure for details)

Name_________________ Street________________________ City_________ State___________ Zip_______Current School_________________ Coach__________________

Birth date_________ Age___ Weight___ Height___

Shirt Size___ Grade/Fall 2008___

Circle Program Date: August 10th - August 15th, 2008

Position____________ Roommate request_______________

Parent/Guardian______________________ Phone(h)_____________ (w)_____________ Email____________________

Parent/Guardian Signature_______________________________

Make checks payable to: Brewster Academy Soccer School

Send to: PO Box 21, Franklin, NH 03235

Please send either full tuition or a non-refundable $100 deposit with the application. The balance is due 2 weeks before the start of camp.

*List other players registering with you to receive a 10% tuition discount. Registrations must be mailed in together at the same time in order to receive the 10% discount.

1)______________________ 2)_____________________ 3)___________________

4)______________________ 5)_____________________ 6)___________________

*Brewster Academy, The Soccer School, and their staff members are not responsible for accidents resulting in medical, dental or other expenses. Each participant must obey the Soccer School rules or risk being sent home at his or her parents’ expense.

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