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Youth Pirate Soccer Camp
Pirates Youth Soccer Camp 2025
1
Complete Form
2
Payment
3
Confirmation
Option:
--Select--
Players 5th - 8th grade
Price:
$30.00
Description:
Youth Pirate Soccer Camp
= Required Field
Footballer Information
--Select Player--
GENDER
Please select...
Male
Female
CITY
STATE
--Select--
AK
AL
AR
AZ
CA
CO
CT
DC
DE
FL
FM
GA
GU
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MI
MN
MO
MS
MT
NC
ND
NE
NH
NJ
NM
NV
NY
OH
OK
OR
PA
PR
PW
RI
SC
SD
TN
TX
UT
VA
VT
WA
WI
WV
WY
AB
BC
MB
NB
NF
NT
NS
NU
ON
PE
QC
SK
YT
DATE OF BIRTH
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AGE GROUP
('25-'26)
Please select...
U11 (2015)
U12 (2014)
U13 (2013)
U14 (2012)
U15 (2011)
Cell Phone
SHIRT SIZE
--Select--
YS
YM
YL
YXL
AS
AM
AL
AXL
School
('25-'26)
:
Grade
('25-'26)
:
--select--
5
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Emergency Contact
Emergency #
BHS Youth Camp Waiver
I the undersigned (if applicant/participant is 18 years of age or older) or parent/guardian of the above listed minor applicant/participant acknowledge and fully understand that each applicant/participant will be engaging in activities that involve risk of serious injury, including permanent disability or death, and severe social and economic losses which might result not only from their own actions, inaction or negligence, but action, inaction or negligence of others, the rules of play, or the condition of the premises or of any equipment used and further, that there may be other unknown risks not reasonably foreseeable at this time, assume all the foregoing risk and accept personal responsibility for the damages following such injury, permanent disability or death, hereby release, discharge, covenants to indemnify and not to sue Boonville High School, Boonville Soccer Academy, and their affiliated organizations and sponsors, their coaches, managers, employees and associated personnel, officers, directors, agents, including the owners and leasers of premises used to conduct the event, all of which are hereinafter referred to as 'releasees', from any and all liability to each of the undersigned, his/her heirs or next of kin for any and all against any claim by or on behalf of the applicant as a result of the applicant's participation in the Programs and/or being transported to or from the same, which participation, after careful consideration I hereby authorize, and which transportation I hereby authorize. The applicant/participant has received a physical examination by a physician and has been found physically capable of participating in the Programs. I hereby give my consent to have an athletic trainer, coach and/or doctor of medicine or dentistry or associated personnel to provide the applicant/participant with medical assistance and/or treatment and agree to be financially responsible for the cost of such assistance and/or treatment. I, also agree to save and hold harmless and indemnify each and all parties herein referred to above as releasee form all liability, loss, cost, claim or damage whatsoever, including death or damage to property, which may be imposed upon said releasee because of any defect in or lack of such capacity to so act or caused or alleged to be caused in whole or in part by the negligence of the releasee. I have read the above waiver/release and understand that (I)we have given up substantial rights by signing this release and sign below voluntarily.
CONTACT INFORMATION
GUARDIAN #1
Same as player
STATE
--Select--
AK
AL
AR
AZ
CA
CO
CT
DC
DE
FL
FM
GA
GU
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MI
MN
MO
MS
MT
NC
ND
NE
NH
NJ
NM
NV
NY
OH
OK
OR
PA
PR
PW
RI
SC
SD
TN
TX
UT
VA
VT
WA
WI
WV
WY
AB
BC
MB
NB
NF
NT
NS
NU
ON
PE
QC
SK
YT
ZIPCODE
1 of the 3 phone numbers below must be filled in
HOME
WORK
CELL
PREFERENCE
Home
Work
Cell
I would like to volunteer
Coach
Assist. Coach
Field Marshall
Referee
Team Manager
GUARDIAN #2 (optional)
Same as player
STATE
--Select--
AK
AL
AR
AZ
CA
CO
CT
DC
DE
FL
FM
GA
GU
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MI
MN
MO
MS
MT
NC
ND
NE
NH
NJ
NM
NV
NY
OH
OK
OR
PA
PR
PW
RI
SC
SD
TN
TX
UT
VA
VT
WA
WI
WV
WY
AB
BC
MB
NB
NF
NT
NS
NU
ON
PE
QC
SK
YT
ZIPCODE
1 of the 3 phone numbers below must be filled in
HOME
WORK
CELL
PREFERENCE
Home
Work
Cell
I would like to volunteer
Coach
Assist. Coach
Field Marshall
Referee
Team Manager
Add another footballer
CONTINUE
Refund Policy
Fees and Other Expenses
All player fees must be paid in full at the time of registration.
Return of Fees/Reimbursement
Any Player not accepted into the BHS Pirates Youth Camp would have registration fees returned.
No refunds will be given for weather cancellations, however every effort will be made to reschedule. The rain date will be July 24th.
Contact Info
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