SWSA DAY CAMP APPLICATION
COMPLETE THE FOLLOWING FOR EACH CHILD REGISTERING
AND RETURN WITH YOUR REGISTRATION FEE TO:
PENN SOCCER ACADEMY
POBOX 31811
PHILADELPHIA, PA 19104
(Please make checks payable to Darren Ambrose Soccer Camps
OR Register online at
Confirmations, details for check in and check out, anda list of items each camper should bring to camp will be sent via email in early June. You can also find this confirmation letter on our website anytime at under Forms and Directions. We cannot accept applications that are incomplete. Please fill out each section. Please include your insurance information.
CAMPER NAME______AGE AT CAMP______T-SHIRT SIZE______
ADDRESS______CITY______
STATE______ZIP______EMAIL ADDRESS(print)______
TRAVEL TEAM NAME (Only if attending with a team of 10+ )______
MOTHER’ S NAME______FATHER’S NAME______
MOTHER’S DAY PHONE______FATHER’S DAY PHONE______
MOTHERS’S CELL PHONE______FATHER’S CELL PHONE______
EMERGENCY CONTACT NAME ______CONTACT NUMBER______
YES, I WOULD LIKE TO PURCHASE A BALL for $15 (check box) Size 3 (ages 5-8) ____ Size 4 (age 9-11)____ Size 5 (age 12+)____
(a ball will not be included with registration)
Please complete the following.
I certify that this registration fee has not been provided by a representative of Penn athletics interest (booster).
Signature of Parent/Legal Guardian ______Date______
Important: Please Read Carefully!
I hereby request that you accept the application of ______in the 2010 Penn Soccer Academy during the dates set forth in this application, and in consideration of your acceptance of the application, I hereby release the Darren Ambrose Soccer Camps Staff and the University of Pennsylvania, and all their trustees, officers, employees, and agents, from any and all liability or claims relating to any injuries or property loss that may be sustained by the camper while attending the 2010 Penn Soccer Academy or any and all claims which may hereafter be presented by or on behalf of the camper (minor child) relating to such injuries or loss. Such released claims include claims for negligence, gross negligence, or recklessness. In addition, I/We, the undersigned, for ourselves, our heirs, executors, and administrators, waive, release and forever discharge Darren Ambrose Soccer Camps, Inc., its staff, officers, agents, employees, representatives, successors, and assign of and from all rights and claims from damages, injury or loss to person or property which may be sustained or occur during participation in camp activities or while at camp, whether or not the damages, injury or loss is due to negligence.
Signature of Parent/Legal Guardian ______Date______
Important: Please Read Carefully!
Authorization for Medical Treatment and Release: In case of emergency or if any medical attention is required by my child, I hereby give my permission to the Penn Soccer Academy staff and/or Penn to secure medical treatment and to act on my behalf according to their best judgment, and I hereby release the Penn Soccer Academy and the University of Pennsylvania, and all their trustees, officers, employees, and agents, from any and all claims relating to the exercise of such judgment.
Signature of Parent/Legal Guardian ______Date______
PO Box 31811
Philadelphia, PA 19104
Dear Soccer Enthusiast,
In conjunction with Swedesboro/Woolwich Soccer Association (SWSA), I am extremely happy to invite you to join us this summer for a fun filled week of soccer games, exercises and competitions at Locke Avenue Park. The enclosed flyer offers you details of the camp to be held August 2-6 from 9am to noon. Boys and girls ages 5-13 are welcome to register.
I am delighted to have been offered the opportunity through SWSA to bring our camp back to the area for the fourth year. Our staff includes players and coaches from The University of Pennsylvania as well as other local college coaches and club coaches. All of our staff are professional coaches and know how to work with you to increase your soccer skills and also your love of playing the game. In addition, several players from area colleges will also be on hand as coaches and role models. Our goal is to offer a fun, supportive soccer experience, while helping you develop your skills to play the game. Every day we will have games and skill competitions. We know you will have a great week of camp with us. Of course we will also play the camp favorite game “Drip Drip Drop”!!!!
Once again this fall, we will be inviting everyone from SWSA to attend a Penn soccer match where you can watch the players who work with you in action in a college game! You will also get to meet the team after the game!
To maximize the experience for every camper we will be limiting enrollment to the first 135 campers that register. Registration fees have been reduced from last year to $140 and $115 for each additional child. Family Max is $400.
A ball may be purchased at cost for $15.
There are two ways to register. You can choose the one that is most convenient for you.
1. Go online to and click the “SWSA Day Camp” link on the main menu on the left side of the screen. Click the “register now” button on this screen. Follow the instructions.
2. Mail in the enclosed application with a check for your registration fee for $140 for the first child and $115 for each additional child. Family Max. is $400. Please indicate if you would like to purchase a ball for $15. They will not be included with registration this year.
If after registering you decide for any reason not to attend camp, we will refund all monies minus $25 processing fee. There are no exceptions to this refund policy.
After you have registered, you will receive an email in June confirming your registration and giving you details for the week of camp. In the event of inclement weather during the week, we will add an hour to other days of camp to make up any missed session. In the event that several days are cancelled due to the weather we will issue a prorated refund.
We are looking forward to working with you this summer and having a fun filled week of soccer.
Feel free to email me with any questions at the email below.
Best Wishes,
Darren Ambrose
Director, Penn Soccer Academy
Head Soccer Coach, University of Pennsylvania
PO Box 31811, Philadelphia Pa, 19104**856-535-8960****