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2015 Girls Summer Soccer Camp Application

Mira Costa High School Girls Summer Soccer Camp Application
Fields marked with an asterisk (*) are required.
  • Please read below. These steps will make your registration process go smoothly:
    • Ages: 6 - 12
    • Dates: Monday, July 13 - Friday, July 17
    • Time: 1:30 - 4:00
    • Place: Manhattan Village Turf Field
      1300 Park View Ave.
      Manhattan Beach, CA 90266
    • Hosted by: Mira Costa High School Girls Soccer Team
    • Cost: $185 - $165 for siblings

    Low player to counselor ratio! Fun activities! Photographer on site!

    Camp is directed by Head Coach Patty Perkinson, and Amanda Cross, Varsity Coach. Camp counselors are all Mira Costa Girl's Soccer Team players.
  • To enroll, please fill out the form below
    Enrollment information: You must fill out a separate registration form for each camper.
  • Date Format: MM slash DD slash YYYY
  • In the event I cannot be reached, permission is hereby given for the physician or hospital designated below to provide emergency care for my child should serious illness/injury occur during camp hours. I also authorize the Mira Costa High School Girls Soccer Camp Director or member of the Soccer Camp staff to offer consent to medical attention by calling 911 and/or to offer consent as needed.
    To pay by check, please check the box above and mail your check made out to MBX - Costa Girls Soccer to:
    Leslie Whittet
    1609 10th Street
    Manhattan Beach, CA 90266