Please mark the appropriate program, session,
location and fill out the form completely
June 29 - July 5 * Northwood/Lake Placid. Overnight, Day and Mighty mites
July 13- 19 * St. Lawrence University.
July 13- 19 * St. Lawrence University. " JUNIOR ELITE AGES 11-13 "
July 19 - 26 * St. Lawrence University. " ELITE FIELD PLAYER 14 + "
July 19 - 26 * St. Lawrence University.
August 10 - 16 * Northwood School, Lake Placid.
June 29 - July 5 * Northwood School " MIGHTY MITES "
July 13 - 19 * ST. Lwarence University " MIGHTY MITES "
July 19 - 26 * ST. Lwarence University " MIGHTY MITES "
August 10 - 16 * Northwood School " MIGHTY MITES "
July 19 - 26 * St. Lawrence University. " ADVANCE GOALKEEPER "
July 27 - August 1 * St. Lawrence University. " TEAM CAMP "
Overnight Camper
Day Camper
Goal Keeping (please check also)
Mighty Mites (w/ball)
Mighty Mites (w/out ball)
Special Session or Program: (check information as needed )
Returning Camper? : Yes No
Last Name:
First Name:
Street Address:
City:
State/Province:
Zip Code:
Area Code:
Phone:
Email:
Gender:
Male: Female:
Age when camps starts required:
Date of birth:
Roommate requests: Lake Placid Soccer Centre takes requests for specific roommates, but it cannot guarantee them. Rooming information will not be given out prior to the start of camp. Requests for room changes are reviewed each Sunday evening only.
Name of Roommate(s) Requested:

IMPORTANT: If you register online, you still need to fill out a
medical form and mail it in or bring it with you to camp.
Download the medical form here.
I understand that Lake Placid Soccer Centre is not responsible for accidents resulting in medical, dental or other expenses, including loss of personal items. The camp participant will be held responsible for all property damage and may be sent home without a refund for violation of camp rules. The applicant must be in good health and be able to participate in the physical activity of a vigorous program. A health form to be completed by the applicant's physician will be sent with the camper's confirmation letter and must be presented before or on arrival at the camp. A non-refundable deposit is required for this application to be accepted, with the balance due on or before the first day of camp. In the event I cannot be reached, it is permissible for LPSC, to have a doctor/hospital treat my child for medical reasons.
 I Agree  

Health Insurance Company:
Policy Number :
Group Number :
Comments:

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