2011 Youth Camp Registration

Click here to download the .pdf to fill out and mail in

OR

Please fill out the form below. After completing & submitting the form, please make your checks payable to Olentangy Liberty Soccer and mail it to:

Liberty Patriots Youth Summer Soccer Camps
3584 Home Rd
Powell, OH 43065

  • Please Enter what Grade Your Child will be Entering (1st Grade through 6th Grade only)
  • I hereby agree and promise that I will not hold the camp, coaches or the Olentangy School District responsible for any losses, damages, or personal injuries that might occur as a result of participation. In the event of any injury, if attempts to contact me or my spouse at the above numbers are unsuccessful, I give my permission for my child to be transported to the _______________________ Hospital/Emergency Room and for them to be treated by the medical staff of that facility.
  • I confirm that my child is physically fit to participate in the camp and is adequately covered by medical insurance. By typing 'I AGREE' you are digitally signing this registration form for submission. You may be required to physically sign a form on the first day of camp.