DO YOU HAVE WHAT IT TAKES?
TOP 150 GIRLS
PLAYER REGISTRATION
AND BIOGRAPHY
LAST NAME:

FIRST NAME:

NICKNAME:
AGE:                                                          DATE OF BIRTH
HEIGHT                                                           WEIGHT
GRADE                        SCHOOL                       GRADUATION YEAR
ADDRESS:

CITY:

STATE:

ZIP CODE

PHONE #:

EMAIL:

TRAVEL/AAU
TEAM:

FAVORITE
ATHLETE:

HOBBIES:





POSITION:
T-SHIRT SIZE           UNIFORM TOP         UNIFORM BOTTOM
INSURANCE CARRIER:


POLICY #:


GROUP #:
In case of emergency
please contact:

NAME:

RELATIONSHIP TO
PLAYER:

PRIMARY PHONE #:

SECONDARY PHONE #:
I, the undersigned, consent that my son is physically fit and
able to participate in strenuous activity and hereby waive New
England Regional adidas Phenom Camp and City Legends of
all responsibility for illness or injury sustained.  I hereby
authorize camp personnel and/or directors to act on my behalf
in the event of a medical emergency.  I understand that I am
solely responsible for payment of all medical expenses.

I waive all financial claims and understand that all photos and
videos taken during the camp are the property of the New
England Regional adidas Phenom Camp and may be used for
promotional use.  

I also understand that my payment is non-refundable and
non-transferable under any circumstances.
I consent to the disclaimer as stated above.
ADDITIONAL COMMENTS
Payment:
Make checks payable to:
Eskills Academy
718 Marian Dr.
Middletown, DE 19709
Required:
Send (upload) and a clear head shot photo of individual player to
info@nephenom.com
Please include name, high school, year of graduation, city and state.
NEW ENGLAND REGIONAL
PHENOM TOP 150 CAMP
GIRLS
DATE
October 11-12th 2009

LOCATION
The Rivers School
333 Winter St
Weston, MA

COST: $195
Camp Times:
Registration to open at 7:30
Saturday 9:00 am to 3:00 pm
Sunday   9:00 am to 3:00 pm

Grades:  9th, 10th, 11th and 12th Grade
60 players maximum in each division