2025 Boys Soccer Camp ~ June 16-19

logo

2025 McGill-Toolen Catholic High School

Boys Soccer Camp- June 16-19
Ages: K5 to 8th grade

Location: Lip at 5-7 pm
Cost: $100 make check payable to Nate Nicholas
Items to Bring: Soccer Ball, Water Bottle, money for light concessions

Payment due at gate or mail to the school (cash or check)

Checks made payable to Nate Nicholas

1501 Old Shell Rd. Mobile, AL 36604

Please complete the form below. Required fields marked with an asterisk *

Participant Information

First Name (Participant Name)*

Answer required for "First Name (Participant Name)"

Middle Name (Participant Name)*

Answer required for "Middle Name (Participant Name)"

Last Name (Participant Name)*

Answer required for "Last Name (Participant Name)"

What school do you attend? *

Answer required for "What school do you attend? "

Age*

Answer required for "Age"

Grade for the 2022-2023 school year*

Answer required for "Grade for the 2022-2023 school year"

Kindergarten

1st

2nd

3rd

4th

5th

6th

7th

8th

Date of Birth*

Answer required for "Date of Birth"

Home Address*

Answer required for "Home Address"

City*

Answer required for "City"

Zip/Postal*

Answer required for "Zip/Postal"

I hereby give my consent for my child to participate in all camp program activities and release McGill-Toolen Catholic High School, its' coaching staff, its' officers, directors, agents, and employees from any and all liability for personal injury arising from my child's participation in the program. If at any time it is necessary for the player to receive outside medical attention, I hereby give my consent to the program to secure the services and arrange transportation if deemed necessary. I am also aware I will be responsible for any and all medical expenses resulting from sickness or injury during the program. *

Answer required for "I hereby give my consent for my child to participate in all camp program activities and release McGill-Toolen Catholic High School, its' coaching staff, its' officers, directors, agents, and employees from any and all liability for personal injury arising from my child's participation in the program. If at any time it is necessary for the player to receive outside medical attention, I hereby give my consent to the program to secure the services and arrange transportation if deemed necessary. I am also aware I will be responsible for any and all medical expenses resulting from sickness or injury during the program. "

Yes (please check)

Parent/Guardian Name (Electronic Signature for consent) *

Answer required for "Parent/Guardian Name (Electronic Signature for consent) "

Special Custodial Information (if needed)

Answer required for "Special Custodial Information (if needed)"

Email *

Answer required for "Email "

Mobile Phone*

Number Required

Home Phone*

Number Required

Emergency Contact Name*

Answer required for "Emergency Contact Name"

Emergency Contact Phone Number*

Number Required

MEDICAL INFORMATION

Physician Name*

Answer required for "Physician Name"

Physician Phone Number*

Number Required

Health Insurance Company and Policy Number*

Answer required for "Health Insurance Company and Policy Number"

Preferred Hospital*

Answer required for "Preferred Hospital"

Allergies? *

Answer required for "Allergies? "

YES

If child has allergies, please explain and medicine taken

Answer required for "If child has allergies, please explain and medicine taken"

Other medical conditions?*

Answer required for "Other medical conditions?"

YES

If other medical conditions, please explain

Answer required for "If other medical conditions, please explain"

Permission to get treatment if parent is not reachable?*

Answer required for "Permission to get treatment if parent is not reachable?"

YES

Please fix the highlighted areas below before submitting.

2025 Boys Soccer Camp ~ June 16-19