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Step 1 of 2

Thank you for choosing to register online. Please carefully enter the following information and then submit. Please remember to submit payment within 2 days to ensure processing of your registration. Check your e-mail for verification.

Hover your mouse over any prompt for helpful information.
Required fields are marked with a star ('*').

Tooltip1 Camper Information

Name*
Gender*	Male Female
Date of Birth*
Age*
School
Club or Team
Position*	Field Player Goalkeeper
Years playing soccer*
Shirt size*

Should we know of any additional medical information or allergies?
Yes (Please explain below)
No

Please provide any medical information or allergies here:

Tooltip2 Parent/Guardian Registrant Information

Parent/Guardian Name*
Address*
City*
State*
Zip*
Home Phone Number*
Alternate Phone Type*
Alternate Phone Number*
E-Mail Address*
New to Fast Feet*	Yes No

New Registrant Information

You indicated above that this is your first time registering for Fast Feet Soccer Camp. Welcome to the family! We would appreciate if you would let us know the following additional information.

How did you hear about Fast Feet Soccer Camp?

If you were recommended to our camp, who recommended you?

Registration Details

Camp*	High School (Ages 15+) Full Day (Ages 9-14) Half Day (Ages 6-8) Mini Camp (Ages 4-5)
Sessions*	June 28 - July 2 July 5 - July 9 August 2 - August 5 (High School only)
Soccer Ball*
Photo Gallery Pass*
Ball Size*	3 4 5
Comments or Requests

Tooltip3 Payment Information

Please select one of the following methods of payment.

Payment Method*	Credit Card Check Cash
We accept:

Payment by Check

If paying by check, please also submit the following information to ensure that your payment is processed correctly.

Name on Check

Check Number

Payment by Credit Card

If paying by credit card, please also submit the following information to ensure that your payment is matched to your registration. You will be given the opportunity to process your payment through our secure Google Checkout service on the next page.

Please do not enter your credit card number on this page.

Cardholder's Name

Credit Card Type

Liability Waiver and Photo Release

I have read and agree to the liability/medical waiver below. (Required)
My son/daughter is in good health and has my permission to participate in this program. In case of medical emergency, I authorize FAST FEET personnel to seek medical emergency care for my child. I hereby assume all risks and hazards incidental to my child's participation in FAST FEET activities and I do herby waive, release and absolve the FAST FEET director, assistants and participants from any claim arising out of injury to my child. I represent that I am a parent/guardian of the minor named above, and I agree that the grant and release contained therein binds me and the minor to all of its terms.

I have read and agree to the photo release below.
I agree that photo's taken of my child at Fast Feet Soccer Camp can be displayed on the Fast Feet Soccer Camp Website. (If you do not want your son or daughter's image posted on the website, please conatct Coach Smith.)

Verification
Please carefully type the black letters and numbers you see into the box to verify your submission (not case sensitive).
Warning: An incorrect verification response may clear the whole form.

Submission
Please submit this form once you have verified the above information.

Having trouble submitting this form? Please check that you completed all of the required fields above. Required fields are marked with a star ('*') and will display an error message bellow them if you try to submit the form without entering a correct value.

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Fast Feet Soccer, Inc.
576 Valley Road
Wayne, NJ 07470
(201) 934-1902