Do you have what it takes to be Elite?
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Player Full Name *

 
Player Gender *


 
Player Date of Birth *

 
Address

 
1st Line of Address

 
2nd Line of Address

 
City

 
State

 
Zip Code

 
Country

 
Parent Name

 
Phone Number *

 
Camp Times

Morning Session
9:00 AM - 12:00 PM players ages 7 to 10

Afternoon Session
1:00 PM - 4:00 PM player ages 11 to 15

 
Which camp do you wish to participate in? (Please select all that apply) *


 
Which one is your Age Division *


 
Name of your futsal club

 
Name of your soccer club

 
T-Shirt Size *


 
Your total is{{var_price}} *

 
Please enter your Credit or Debit Card number: *

 
The CVC number: *

(3 or 4 digit security number on the back of your card)
 
The name on your card: *

 
Your card's expiry month: *


 
Your card's expiry year: *


Your application has been successfully submitted. You will receive a confirmation email with more information about the camp.
Thank you!
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