2004 & 2005 Maryland State Champions

2005 #23 NSCAA/Adidas National Ranking
2005 NSCAA/Adidas National Team Academic Award
2006 NSCAA/Adidas National Team Academic Award
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Tuscarora High School
5312 Ballenger Creek Pike
Frederick, MD 21703
240-236-6547

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Titans Soccer Camp Registration
Fully complete this application form. If you have any question, please contact the Titan Soccer Camp via e-mail at camp@titanssoccer.org or call 240-236-6547.

Note the response required indicates response required

 
Player Personal Information
response required First Name
response required Middle Initial
response required Last Name
response required Address
response required County
response required City
response required State
response required Zip
response required Home Phone
(e.g. 301-123-4567)
response required DOB response required Gender response required T-Shirt Size
(e.g. 03/06/94)
response required Fall 2008 Grade in School

Parent/Guardian Information
response required E-mail Address
response required Father/Guardian First Name
response required Last Name
response required Work Phone
(e.g. 301-456-7890)
response required Mother/Guardian First Name
response required Last Name
response required Work Phone
(e.g. 301-890-7654)

Player Emergency Contact Information
response required Emergency Contact First Name
response required Last Name
response required Phone Number
(e.g. 301-456-6543)
response required Doctor First Name
response required Last Name
response required Phone Number
(e.g. 301-789-5678)
response required Medical Insurance Company
response required Policy Number
Once you have completed this form, you may wish to print it for your records. Please use your web browser's print icon to perform this task.

 

  
 

Tuscarora High School Girl's Soccer
Copyright © 2007