Registration  Spring & Summer 2012

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Name:
Address:
City: State: Zip:
Home Phone: Emergency phone :
Date of Birth: Grade:
T-Shirt Size: Email:(print clearly)
Please check the session you wish to attend:
SPRING & SUMMER 2012 SESSIONS
College Prospect Academy
Spring Break Academy-Belmont

April 17-20- at Winnbrook School in Belmont, MA

1/2 day  9am-1pm $150, full day $215                    


Bentley University- High School aged players only

August 13- 16 at Bentley University
please call for hotel info if from out of town

12-5pm,                                 $215           

Summer Academy& Clinics
1/2 day clinic runs from 9:00 -12:00 full day clinic runs from 9:00 - 3:00 (unless otherwise noted)
Belmont Advanced Training Academy June 11-July 11 Mon & Wed 10 sessions 4pm  (8-10 ages) or 5:30pm  (ages 8-14) $125
Bentley University- Waltham, MA August 13-16 Mon-Thu 1/2 day $125, full day $215
Grafton -Wyman-Gordon Field Jul. 23 - 26  Mon-Thu 1/2 day $125, full day $215
Mendon/Upton - Memorial Elementary School in Upton Aug.6 - Aug. 9 Mon-Thu 1/2 day $125, full day $215
Belmont - Belmont Middle School
 Aug. 20 - 23 Mon-Thu 1/2 day $125, full day $215

Winchester-site TBD

 July. 30 - Aug 2 Mon-Thu 1/2 day $125, full day $215


You will also need to attach a Medical Release Form as well..


No application will be accepted without the Medical Record Form.
Your cancelled check will serve as confirmation.

You will receive an email reminder letter so please include a working email address.


*Please send your checks to Soccer 101 Academy, Inc.

PO Box 380564

Cambridge, MA 02238


*Please make all checks payable to Soccer 101 Academy

Call 617.997.8092-Visit our website www.soccer101academy.com-Email us at gcrompton@bentley.edu