St. John’s University - Oakdale, NY
REGISTRATION FORM
 
 

To apply for this Pro Player camp:
1. Fill in the Application Form on the computer and print out a copy, OR print out a copy and fill it out with a pen.

2. CLICK HERE for the Pro Player Camps MEDICAL RELEASE FORM. This must be completely filled out and brought to the first day of camp.
 
NAME
  
HIGH SCHOOL
  
ADDRESS
  
CITY
  
STATE
  
     
ZIP
  
           
PHONE
  
WORK PHONE
  
EMAIL
        
POSITION
  
GOALIE     DEFENSE    MIDFIELD    ATTACK
GRADUATION YEAR
  
DATE OF BIRTH
  
SEX
   MALE      FEMALE
AGE
  
HEIGHT
  
WEIGHT
  
CAMP SESSION(S)
BOY'S SESSION - June 7 - July 11

 
BOY'S SESSION - July 14 - July 18
 
CAMP TUITION
  FULL PAYMENT (per session)
$375 each
 
DISCOUNTS
Early Registration - Enroll by 4/20/06     $40 OFF

CHECK ONE ONLY

NOTE: You are only able to qualify for one discount

Team discount – take $25 off for each team member or friend
   (3 or more – must be sent together)     $25 OFF
Family Discount – take $25 off for each family member
   (2 or more)     $25 OFF
Multi Camp Discount – take off $70 total registration fees
for multiple sessions     $70 OFF  this application only
TOTAL
  
PAYMENT
  
CHECK ONE ONLY
My FULL PAYMENT (shown ablove) is enclosed
My NON-REFUNDABLE DEPOSIT of $150.00 is enclosed
 
BALANCE DUE         
 
  WAIVER RELEASE:

For good and valuable consideration, receipt of which is hereby acknowledged, we the undersigned, for ourselves, our heirs, executors and administrators, waive, release and forever discharge Pro Player Lacrosse Camps, its staff, officers, agents, representatives, employees, successors of and from all rights and claims for damages, resulting from injury or property which may be sustained or occur during participating camp activities or arising from travel to or from camp, whether said damages, injury or loss are due to negligence or not

Applicant's Signature ______________________________________________ Date ________
Parent/Guardian Signature _________________________________________ Date ________
Health Insurance______________________________________________________________
Claim #______________________________________________________________________
 
           
 
PLEASE MAIL APPLICATION AND DEPOSIT TO:
Pro Player Lacrosse Camps
P.O. Box # 610 Bayport, NY 11705 
Phone 631-750-5978
ONCE YOU HAVE SENT IN YOUR APPLICATION/DEPOSIT - you will receive a confirmation by June 20th via mail including directions, what to bring, medical forms, and detailed camp sign-in information
ENROLLMENT IS LIMITED! FIRST COME — FIRST ENROLLED!
  
   
MAKE CHECKS PAYABLE TO:  Pro Player Lacrosse Camps
   
 

  PAYMENT and REFUND POLICY:   

 
    All payments are final, unless cancellation is due to a health-related emergency, in which case a 50% refund may be processed with a note from a medical doctor.