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Williamsburg Junior Athletic Association

Williamsburg Junior Athletic Association

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Jun, 2019

Youth Summer Soccer Camp June 10-12

When: June 10, 11 & 12 2019
Time: 6pm-730pm Please arrive by 545pm
Location: Williamsburg High School Soccer Fields
500 South 5th St Williamsburg, Ohio 45176
Who: Children entering grades 1st – 7th grade 
Please bring gym shoes shin guards and a water bottle
**** NO CLEATS****
Cost: $40 per person- If you sign up on or before May 28, 2019 you will receive a Williamsburg Soccer T-shirt 
Please make checks payable to Williamsburg Schools 
Staff: Brian Hart and Craig Beesten, are licensed and coached Club soccer for 6+ years. They are current coaches for the Williamsburg Women’s Soccer Team.

Registration Form
Name _________________________________________________
Address _________________________________________________
School __________________________ Entering Grade (2018-2019) ____________
Contact # __________________________ Emergency # ___________________
T- Shirt Size YS ___ YM ___ YL ___ AS ___ AM ___ AL ___ AXL ___ FOR EARLY REGISTRATION ONLY
Email/Mail Registration form to Brian Hart 4295 Dela Palma Rd Williamsburg, Ohio 45176 or [email protected] Questions 513-910-6816
Release: For and in consideration of participation by _________________, in the soccer camp to be held Participant’s Name
At Williamsburg, High School June 10, 11 & 12, 2019.
I agree to hold Williamsburg Soccer Camp and its employees harmless and to waive the right to bring legal action against it and its employees for any injuries sustained during the course of this soccer camp. If necessary, I authorize the camp director to administer first aid and or authorize medical treatment if it becomes necessary. The above participant has had a medical examination within the last twelve months. This agreement and waiver, having been read thoroughly, and understood completely, is signed voluntarily as to its contents and intent.
_________________________________ __________________________
Signature of Parent/Guardian                                        Date


W.J.A.A. Williamsburg Junior Athletic Association
3759 Old State Route 32 
Williamsburg, Ohio 45176

Email: [email protected]

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