Golden Touch Soccer

Golden Touch Online Application Form

Some applicants have experienced some problems with the online form below. If you have problems, or experience an error during the process, please copy the error message into an email, and send it to ABlewitt@msn.com.

If you continue to experience problems, please download the PDF version of the Application (click here), and mail it to the Camp Director.

First Name:

Middle Initial:

Last Name::

Gender:

Male

Female

Address:

City:

State:

Zip:

Phone:

Emergency Phone:

Emergency Contact:

Email Address:

Date of Birth:

Current Age:

Select Camp:

Day Type:

Full Day Camper

Half Day Camper

Baby Bears

College Prep

Parent / Guardian Name:

Field Player:

Goal Keeper:

Yes I will be purchasing a Camp Ball
(add $20.00 to camp cost)

(check for yes)

Select Camp Ball Size:

Size 4

Size 5

Camp T-Shirt Size:

Wavier and release: In consideration of my application being accepted,
I, intending to be legally bond, do hereby, my heirs,
executors, and administrators, waive and release, and forever discharge
any and all rights and claims for damages which I may
have or which may here accrue to me against Adrian Blewitt, Golden Touch Soccer Camps,
Golden Touch employees. Or any agency hosting a camp, or their respective employees, officers, agents,
representatives, successors and or assigns, for all damages which may be
sustained by me in connection with, or participation in, or rising out of travel to and returning from said camp.

I acknowledge and concur with the
above wavier and release statement and
allow the above said camper to participate
in the Golden Touch Camp.:

(Check if yes)

© GoldenTouchSoccer.com
E-Mail: ABlewitt@msn.com | Ph. (828) 260-1690

Golden Touch Soccer Camps,
3037 11th Ave Dr, NE,
Conover, NC 28613