June 11, 2015
9:00am to 1:00pm
Join us for a fun day
of soccer activities
Location: Lady Eagle Soccer Field
Cost
$20.OO if your
registration is received by
May 29, 2015
$25.00 after May 29,2015
Camp features:

Instruction from Belen
High School Girls’ Soccer
team

Soccer skill work

Team work and cooperation
skills

T-shirt

Lunch at Belen High School

Belen Fire Truck 1:00pm
At Belen High School
For boys and girls
ages 6-13
Lady Eagles’
Soccer Camp
2015
Campers should wear/bring:
Work-out clothes
Cleats (if you have them)
Water bottle
Money for Kona Ice
Don’t forget sunscreen!
For more information call Coach Crystal Cordova at 505– 966-1816 or 505-304-3438
Make check payable to: Belen Girls’ Soccer
Fill out and detach along with $20.00
May be mailed to: Coach Cordova 19383 HWY 314 Belen, NM 87002 ATTENTION: Crystal Cordova
————————————————————————————————————————————————————————————————————————————
PLEASE PRINT: Soccer Camper’s Name __________________________________________________
Parent/Guardian Name_____________________________________________________________
Home Phone__________________ Address_____________________________________ State_______ Zip_________
Age _____ Date of Birth ______________ T-Shirt Size _________________
In case of an emergency name/phone number ____________________________ ____________________________________
Insurance Waiver
I hereby approve of my child’s participation in the 2014 Belen High School Soccer Youth Camp. I accept full
responsibility for any and all injuries or damages received by the participant. I hereby waive and release the
camp director, coaches, and camp workers from any and all liability due to illness or injury incurred while
participating in this camp. I hereby authorize the directors of the BHS soccer camp to act for me according to
their best judgment in any emergency requiring medical attention.
Parent/Guardian Signature_______________________________________________________________