NC State Soccer School for Boys

2008 Camp Application

You may also apply through our secure online application

Campers Name: __________________________________________________________________________________

Addresss: _______________________________________________________________________________________

City/State/Zip: ___________________________________________________________________________________

Home Phone: __________________________ Email Address: ________________________________________

Age at Camp: ___________ Date of Birth: ___________________ Grade (as of 01/01/08): __________________

Parent's Name: __________________________________________________________________________________

Business Phone: ________________________________ Cell Phone: ____________________________________

Current Team's Name: ____________________________________________________________________________

Coach's Name: _______________________________________________________________________________

Phone: _________________________________________________________________________________________

How did you hear about our camp? __________________________________________________________________

CHECK DESIRED SESSIONS

Sessions

Sessions		Deposit	Balance Due	Total
June 23 - 27	Day Camp Session I Half-Day Camp Session I	$100 $100	$150 $0	$250 $100
July 6 - 10	Residential Program Session I Commuter Program Session I	$100 $100	$350 $225	$450 $325
July 12 - 16	Residential Program Session II Commuter Program Session II	$100 $100	$350 $225	$450 $325
July 21 - 25	Day Camp Session II Half-Day Camp Session II	$100 $100	$150 $0	$250 $100
If you are enrolling in camp as a team, please indicate your team's name and submit applications together.
Team Name: ________________________________________________________________

Please Indicate: Field Player Goalkeeper

T-Shirt Size: Youth: M L Adult: S M L XL

Roomate Request:

First Choice: _____________________________________________________________________________________

Second Choice: ___________________________________________________________________________________

Adidas camp ball:

YES I would like to pre-order an ADIDAS NC State Soccer School Ball FOR $30
A check for the ball needs to be sent with the deposit and application.

I will bring my own camp ball

Airport Transportation:

YES for an additional $15 each way, I would like airport transportation to be provided

Late Pick-up:

Enclosed is an additional $10 per day ($50) for a pre-arranged 5PM pick-up time for Day Campers

MAKE CHECKS PAYABLE TO: THE GEORGE TARANTINI SOCCER SCHOOL AT NC STATE

TO ENROLL:

1. Fill out the application(s) and parental consent form(s) - both can be photocopies

2. Mail items with the NON-REFUNDABLE deposit (teams should send deposits and balances as a group) to:

   3. Fill out and mail the following forms:
        Medical History Form
        Physical Form
        Release Form

               THE GEORGE TARANTINI SOCCER SCHOOL AT NC STATE
               P.O. BOX 5697
               RALEIGH, NC 27650

                    The George Tarantini Soccer School is not affiliated with NC State University

Your canceled check confirms your enrollment in camp. You will receive an information packet with final details. Questions may be answered by calling (919) 851-1627.

FOR OFFICE USE ONLY
Deposit Received: __________________	Date: _____________	Check #: _________________
Deposit Received: __________________	Date: _____________	Check #: _________________
Balance Due: __________________	Camp Ball: ______________	Transportation: ______________