Munay Summer Camp

	CAMPER INFORMATION
First Name:
Last Name:
D.O.B (mm/dd/yyyy):
Gender:	Male Female
Age:
Shirt Size:
Choose Session:	Week 1 (August 8 - 12) $375.00 Week 2 (August 15 - 19) $375.00 Both weeks - $700.00
	Note: There is NO DAILY PRORATE. There is an additional $100 fee if registered after July 31st. Checks should be made payable to 'Munay Soccer Academy' and sent to P.O. Box 1959, Ossining, NY 10562.
	PARENT INFORMATION
Parent/Guardian Name:
Address:
City:
Home Phone:
Cell Phone:
Parent/Guardian Email:
Emergency Contact
Emergency Phone:
Primary Physician:
Program Regulations:	Click here to read Program Regulations. By putting my initials below, I agree to comply with all program regulations.
Parent Initials: