2007 Big Kick/GAMEFACE/Tim Howard Soccer Camp Application
Name: _________________________________________________________________
E-mail: __________________________________________________________________
Address: __________________________________________________________________
City, St, Zip: __________________________________________________________________
Home Phone: _______________________________
School District:  _______________________________
Age: _______        Gender: Male   Female
Grade - Fall 2007: _______        Birthday: _____/______/_________
Is your team attending camp? Yes No -  Name of your team? ____________________________
Position: Field Player   Goalkeeper   Both
Shirt Size: Youth Lg.   Adult Sm.   Adult Med. Adult Lg.   Adult X-Lg.
Ball Size: #3    #4    #5
 
20th Annual Kutztown Residential Soccer Camp/HS TEAM CAMP @ Kutztown Univ.  $25.00 DISCOUNT will be applied to applications for the June 17-21 Residential Camp ONLY if application is received before March 1, 2007.  $150 Non-refundable deposit required with each Kutztown University or TEAM CAMP application.  Full tuition required if applying after May 15, 2007.  $350 Non-refundable deposit required for the EXCLUSIVE TIM HOWARD/GAMEFACE - Memphis, TN Camps.
  Camp(s) Attending:(CHECK ALL THAT APPLY)
Kutztown Residential Soccer Camp - June 17-21, 2007 - Select payment option below
GAMEFACE TEAM CAMP @ Kutztown University - JUNE 17-21, 2007 - Select payment option below
TIM HOWARD GOALKEEPER ACADEMY June 24-28, 2007-Christian Brothers Univ. - Memphis, TN - Select payment option
GAMEFACE ELITE STRIKER CAMP June 24-28, 2007 - Christian Brothers Univ. - Memphis, TN - Select payment option
$150 Non-refundable Deposit - KUTZTOWN UNIVERSITY CAMPS - June 17-21
$350 Non-refundable Deposit - Tim Howard GK/GAMEFACE Striker Camp  June 24-28, 2007-Christian Brothers Univ.
$465 Full Amount for GAMEFACE TEAM CAMP JUNE  17-21, 2007
$795 Full Amount for TIM HOWARD GOALKEEPER ACADEMY June 24-28, 2007 - Memphis, TN
$795 Full Amount for GAMEFACE STRIKER CAMP June 24-28, 2007 - Memphis, TN
$650 Full Amount for Commuters Tim Howard GK Academy/GAMEFACE STRIKER CAMP June 24-28, 2007 - Memphis, TN
$465 Full Amount for Residential Camp June 17-21, 2007
$440 Full Amount for Residential Camp June 17-21, 2007 if Application is received before March 1, 2007
$400 Full Amount for Commuters-JUNE 17-21 ONLY - Includes lunch and dinner
Roommate Requests: 1. ___________________________________/2. _________________________________
*Note: There are limited 3 person rooms. You are not guaranteed a 3 person room.
Payment Information - Make checks payable to:   "Game Face Management, LLC."
Total Amount charged to credit card: $____________  Type: Visa MasterCard
Credit Card#:  _________/___________/___________/____________      Exp. Date:______/_______
Confirmations will be sent via email unless checked here:

RETURN TO:  Game Face Management, LLC | 14 Hawthorne Road, Wyomissing, PA 19609
Phone: 610.670.6848  |  Fax: 610.670.0589  | info@bigkicksoccer.com