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2018 C3 Soccer Camp Registration Form



  • June 10-12 2018, C3 will celebrate their 15th Annual FREE Soccer Camp for boys/girls from 4-10 years old at The Linsly School in Wheeling. Camp is from 6pm to 7:30pm each night. Please register below.


  • Child Information:


  • First Name: (Required)
    MI:
    Last Name: (Required)

  • Child's Age: (Required)

  • Child's Gender: (Required)



  • T-shirt Size: (Required)

  • Parent Information:


  • First Name: (Required)
    MI:
    Last Name: (Required)

  • First Name:
    MI:
    Last Name:

  • Address: (Required)
    City: (Required)
    County: (Required)
    State: (Required)
    ZIP: (Required)

  • We will send you text updates on soccer camp deadlines, field conditions and other news. Please provide a cell phone number you can receive text messages on

  • Phone:
    Contact Preference:
    E-mail: (Required)

  • Emergency Phone: (Required)

  • Waiver and Release:


  • Part 1: Waiver

    The staff and leadership of Covenant Community Church (C3) value your children and will do everything possible to keep them safe; however, accidents happen. I give my child permission to participate in this event and understand that C3 and The Linsly School are not responsible for accidents or losses including, but not limited to, medical, dental, or other expenses and the loss of personal items. I give my permission for C3 to use still pictures and videos for promotional purposes.

  • Waiver: (Required)


  • Part 2: Medical Release

    In case of accident, I hereby grant permission to C3 Staff members and volunteer leaders to transport my child to the nearest medical facility. If I cannot be reached, I authorize the staff at said facility to perform services deemed critical for the health and well being of my child.

  • Medical Release: (Required)


  • Part 3: Insurance Information

  • Insurance Company: (Required)

  • Policy Number: (Required)

  • Group Number: (Required)

  • Allergies or Other Medical Concerns:
Enter This Verification Number (Required)