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Quad Cities / Illinois / Augustana College / Council of Independent Colleges / North Central Association of Colleges and Schools / Rock Island County /  Illinois


To provide your child with prompt medical care, we must have a completed consent form on file. _________________________________________________ Camper’s Name Birthday (M/D/Y) __________________________________________
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Document Date: 2013-04-15 16:14:11


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File Size: 1,03 MB

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Company

Lg / NIKE / Coach / /

Currency

USD / /

Facility

CAMP FEES AND PAYMENT INFORMATION Overnight Camper / CAMP INSURANCE Augustana College First Touch Elite Soccer Academy / Washington University / Club Team / Augustana College / College Center / College Conference / University of Wisconsin-Madison / /

IndustryTerm

medical insurance / secondary accident/medical insurance / telephone reservations / food / /

MedicalCondition

Known Allergies / injury / injuries / /

NaturalFeature

Mississippi River / /

Organization

United States Soccer Federation / Notre Dame University / High School / St. Ambrose University / Augustana College First Touch Elite Soccer Academy / Knox College / Augustana College / REGISTRATION FORM FACILITIES ACADEMY / AC First Touch Elite Soccer Academy / Washington University / University of Wisconsin / College Center / /

Person

Jon Mannall / Stewart / Nikki McLellan / Women / Scott Mejia / Keri Hess / Laurence Thomson / /

/

Position

positive role model for all participants / Assistant Coach / NSCAA Central Region Coach / DIRECTOR Name / Coach / above player / PREMIER / Head Coach / player / Assistant / Conference Coach / Assistant Women’s Coach / Head Women’s Coach / Head / /

ProvinceOrState

Wisconsin / Minnesota / Illinois / Mississippi / Michigan / /

SportsGame

soccer / /

SportsLeague

United States Soccer Federation / /

Technology

cellular telephone / /

SocialTag