Texas Lightning Soccer Camp Registration (* indicates required field)

Player Name: *  Date of Birth: * Gender: * F M Address:  Apt/Unit: .. .. City:  State: TX AL AK AR AZ CA CO CT DE FL GA 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 RI SC SD TX TN UT VA VT WA WI WY WV Zip: Parent Name: *  Phone: *   Email: *  Alt Phone:

How did you hear about the camp: Flyer in Arlington Flyer in Mansfield Friend/other camper Texas Lightning Website Arlington Soccer Association Website Mansfield Soccer Website Other Specify if other:

Select Clinic: * June 7-10, 2010 June 21-24, 2010            Texas Lightning Club or Academy Player

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Adult Small Adult Medium Adult Large Adult X-Large

Current Team Name

Important Notice: * (Check box to indicate you have read) You will need to provide a medical release at check in. These forms are available for you to download on the following page. The recruiting of players for the benefit of any individual, team, club and/or organization is strictly prohibited. Any person having knowledge of any player recruitment if or through this soccer clinic, camp, academy, private lesson, etc., should report same to the Youth Commissioner of NTSSA. The NTSSA Youth Commissioner shall deal with the alleged violations in accordance with NTSSA Rule 3.9 (Recruiting is any action or statement made by anyone, either verbally or in writing that encourages or entices a player to register with a particular coach, team, club and/or organization).