BALTIMORE BLAST SOCCER CLINIC

NOW 9 TIME WORLD CHAMPION
BALTIMORE BLAST SUMMER CAMP
@ Harford Sports Performance Center
SOCCER INSTRUCTION BY MEMBERS OF THE 2017 MASL CHAMPIONS -BALTIMORE BLAST

JULY 31  – AUGUST 4, 2017 9AM TO 5PM

COST IS $250/PLAYER

ALL CAMPERS RECEIVE:
SOCCER BALL * 1 -TICKET TO (4) FOUR GAMES DURING 2017 -2018 SEASON *
CAMP T-SHIRT * INSTRUCTION FROM BALTIMORE BLAST PLAYERS

PARENTS NAME:______________________________________EMAIL ADDRESS:_________________________
NAME:_________________________________________ADDRESS:_______________________________________
CITY:___________________STATE:_____________ZIP CODE:______________     MALE/FEMALE:
AGE :________ T-SHIRT SIZE:__________
PHONE: WORK:_____________________________CELL :___________________________________
Soccer Organization:_______________________________________________________

CAMP LOCATION: HARFORD SPORTS PERFORMANCE CENTER
I_________________do hereby for myself, my heirs, and assigns, waive and release any and all claims to damage against the Baltimore BLAST and any camp locations and it’s assigns or authorized representatives conducting camp as a result of any or all injuries incurred by ____________ traveling to or from, or while participating in the camp.
Make checks payable to: Baltimore Blast Soccer and mail to the address below,

Visit us Online: http://www.baltimoreblast.com/camps/register/

or use your credit card and fax to 410-732-1737.
Please send this completed form along with full payment to:

Baltimore Blast, 6929 Golden Ring Road, Baltimore MD 21237
Credit Card: Visa / MC AMEXCard # _________________________________________________________________
Expdate___________ V #( LAST 3 DIGETS ON BACK OF CARD )
Signature_______________________________________________________________________________