College ID Registration

Email Secondary Email

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2019 CAMP IS SOLD OUT

Name: *

Email address *

Cell Phone: *

Birth Year *

Current address: *

City: *

State: *

Zip Code: *

Father's Name:

Mother's Name:

High School: *

Graduation Year: *

Club: *

Primary Position:

Training Shirt Size: *

Have you already committed to a college or university to play soccer? *

Yes No

If yes to previous question, where have you committed?

Click the following links for Required Forms:

Liability and Medical Release

Bring completed forms to camp check-in or scan and email signed copies to ahunter3@butlercc.edu

Choose your housing option: *

Commuter $200 Residential $200

Roommate Preference:

If staying on campus, please fill in your roommate request. If left blank, we will assign you a roommate.

There will be a $5.00 convenience fee to submit this online form.

* required field