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Matt Kern Soccer Camp at Wofford
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Thank you for applying to the Matt Kern Soccer Camp.
The field marked with (*) are required fields.
* Name
* Age
* Grade
* T Shirt Size
* Street Address
* City
* State
* Zip Code
* Parent/Guardian
* Home Phone
Work Phone
* Email Address
* Early Bird Registration?
Before Thanksgiving (November 23rd) for the Winter Break Clinic.
* Which session will you be attending?
* Emergency Contact
Emergency Phone
* Please list any physical conditions of which our physicians should be aware.
* Insurance Company
* Policy number
* I, the parent/guardian of the above camper, agree that the camper will be engaging in
physical activity during the program which contains an inherent risk of physical injury, and I
agree to assume the risk and release WOFFORD COLLEGE and the MATT KERN SOCCER
CAMP, its directors, and employees from any and all liability from personal injury arising out
of the camper's participation in the camp program.

I hereby grant permission for my child to attend the Matt Kern Soccer Camp and to be treated
by a licensed phycisian or member of the athletic training staff in the event of any injury,
illness, or mishap.
I agree.
Comments? 
*Please print and return the following form*

Release for Medical Treatment/Waiver

__________________________________________________________
Name                                     Date

Please list any physical conditions that physicians should
be aware of:
__________________________________________________________

__________________________________________________________

__________________________________________________________
Insurance Company                        Policy #
The undersigned parent or guardian understands that the
camper will be engaging in physical activity during the
program which contains an inherent risk of physical
injury, and the undersigned assumes the risk and releases
WOFFORD COLLEGE and the MATT KERN SOCCER CAMP, it's
directors, and employees from any and all liability from
personal injury arising out of the camper's participation
in the camp program. I hereby grant permission for my
child to attend Matt Kern Soccer Camp and to be treated by
a licensed physician or member of the athletic training
staff in the event of any injury, illness, or mishap.

__________________________________________________________
Parent of Guardian Signature                     Date
*Please print and return Medical Treatment/Waiver to...
Matt Kern Soccer Camp
Wofford College
429 N Church St.
Spartanburg, SC 29303

*Make checks payable to the Matt Kern Soccer Camp.

*Those attending the Jr. Advanced or College Prep Clinic must send a $50 deposit to reserve spot.

*Full camp tuition and medical waiver may be brought on
first day of camp for those attending youth clinics.
Email Camp Director