EmailMeForm
2018 All Star Football Academy
Coach Scott Kirby and Coach Jay Mayet
​Monday - Thursday, June 18-21
8:00 a.m. - 12:00 p.m.
Boys Entering Grades 2-8
Tuition: $170
0%
Entering what grade level
*
Please select
2
3
4
5
6
7
8
Child's Name
*
First
Last
Child's Address
*
Street Address
City
State / Province / Region
Postal / Zip Code
Child's Birthday
*
MM
/
DD
/
YYYY
Parent/Guardian #1
*
First
Last
Parent/Guardian #1 Relationship to Camper
*
Please select
Mother
Father
Grandparent
Legal Guardian
Does this Guardian have an address that is different than child's?
Please select
Yes
No
Parent/Guardian #1 Address
Street Address
City
State / Province / Region
Postal / Zip Code
Parent/Guardian #1 Cell
*
###
-
###
-
####
Parent/Guardian #1 Work Phone
###
-
###
-
####
Parent/Guardian #1 Place of Business
*
Parent/Guardian #1 Email
*
Is there a second Parent/Guardian to add?
Yes
No
1
/
4
Total
$0.00
