YOU MAY APPLY OVER THE PHONE
CALL US NOW TOLL FREE AT
1-800-KEEPER-1
Please call 1-800-KEEPER-1 to check on availability
If you want to mail or fax in your application, please choose to download the printable version, complete and mail or fax that one-page application to us.
> Printable Camp Application (.pdf) - Coming Soon!
> Looking for the Day Academy? - Click Here

A. Student Information * Student's First Name  * Student's Last Name * Street Address  * City  * State  *  Zip E-mail Address Gender: * Male Female Date of Birth: (mm/dd/yy) ? 01 02 03 04 05 06 07 08 09 10 11 12 * Month ? 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 *  Day ? 99 98 97 96 95 94 93 92 91 90 89 88 87 86 85 84 83 82 81 80 79 78 77 76 75 74 73 72 71 70 69 68 67 66 65 64 63 62 61 60 59 58 57 56 55 54 53 52 51 50 * Year T-Shirt Size:  Size YouthLarge Small Medium Large X-Large * Each Camper will receive a FREE Short-Sleeve adidas T-Shirt   I am one of the following:  Choose One Goalkeeper FieldPlayer Coach   * Roommate Request: (If Applicable) B. Parent or Guardian  The Goalkeeper School participant is in good health and has my permission to participate in camp activities. In the event of an emergency, I hereby give permission to the physician selected by the camp director to secure proper treatment for the student. All pictures or videos taken at camp may be used at the discretion of SoccerPlus.  Name of Parent or Guardian  (Required if Student is younger than 18)  * Home Phone Number  Cell Phone Number C. Program Choose one * GOALKEEPER SCHOOL Challenge Program - Commuter    ($675 in CA) $650 Challenge Program - Resident      ($775 in CA) $750 Competitive Program                  ($800 in CA) $775 National Training Center             ($825 in CA) $800 Core Program           $500 Two Week Academy                  ($1600 in CA) $1,500 FIELDPLAYER ACADEMY FieldPlayer Academy - Commuter  $650 FieldPlayer Academy - Resident    $750 Striker Program                        ($775 in CA) $750 Two Week Academy $1,500 SPECIALTY PROGRAMS Strength, Speed and Power $775 COACHES' PROGRAM Coaches' Program - Commuter       ($525 in CA) $500 Coaches' Program - Resident        ($625 in CA) $600 TEAM PROGRAM Team Week (Northfield-Mt. Hermon, MA) August 16-21 only $550 > 15-20 Players For Each Team  Use Printable Application (.pdf) - Coming Soon! each D. Location and Dates Choose one   State - Location - Date CA1-UCSD, LaJolla, July 12-17, 2009 CA2-UCSD, LaJolla, July 19-24, 2009 CA 2Week-UCSD, LaJolla, July 12-24, 2009 CT1-Suffield Academy, June 21-26, 2009 CT2-Suffield Academy, August 2-7, 2009 CT3 - Suffield Academy August 9-14 CT 2Week-Suffield Academy, August 2-14, 2009 IN-DePauw U, Greencastle, June 28-July 3, 2009 MA1-NMH, Northfield, June28-July 3, 2009 MA2-NMH, Northfield, August 9-14, 2009 MA3-NMH, Northfield August 16-21 ME-Bowdoin College, Brunswick, July 12-17, 2009 NY1-Colgate U, Hamilton July 19-24, 2009 NY2-Colgate U, Hamilton July 26-31, 2009 NY 2Week-Colgate U, Hamilton July 19-31, 2009 OH-OWU, Delaware, OH June 14-19, 2009 PA-Bloomsburg U, June 21-26, 2009 RI-Roger Williams U, Bristol July 26-31, 2009 TX-TCU, Fort Worth June28-July3, 2009 UT-Weber State U, Ogden, July 5-10, 2009 VA-Randolph-Macon, Ashland, July 5-10, 2009 * Note: Please make sure that the program you wish to attend is being held at this location and is still available. For Example: The Striker School is only available at 7 locations. Visit the Schedule Page to check on  availability or call us toll free at 1-800-KEEPER-1. Note: If you are applying for a 2-Week program, please use the comment section below to indicate the program of choice for the first week and for the second week. Call us toll free at 1-800-KEEPER-1 with any questions. E.  Payment SoccerPlus uses Secure Socket Layers (SSL). By using a SSL we ensure that your credit card number is safe. Your credit card number and any information you enter into this form will only be seen by SoccerPlus Camps. I am paying one of the following: * (Full tuition required if applying within 30 days of camp) $250 Non-Refundable Deposit ($500 deposit for 2-Week Academy) Refund Policy Full Tuition I also want to buy an official  SoccerPlus/adidas Camp Ball  for an additional $25 (Note: By selecting "Yes", you will be  charged $25 in addition to the camp tuition) No Yes OPTIONAL In addition to my FREE t-shirt, I also  want to buy a SoccerPlus/adidas  Long Sleeve Training Jersey for an additional $25 (Note: By selecting a size, you will be charged  $25 in addition to the camp tuition) None Youth L S M L XL OPTIONAL $35 value! I will be using the following type of credit card: * Visa      MasterCard     Discover Credit Card Account number:                                             * (Example: 0000-0000-0000-0000) Credit Card Security Code:  * (This is the 3 digit number on the back of your card) Credit Card Expiration Date:    01 02 03 04 05 06 07 08 09 10 11 12 * Month    2008 2009 2010 2011 2012 2013 2014 * Year Name of Card Holder:  * Check here to automatically pay your balance: Yes, please automatically charge the balance to my credit card 30 days prior to the camp start of camp. The confirmation package will include a confirmation letter, a map to and of the campus, a medical form, what to bring list, and pre-camp tips and advice. Note: If applying for our Two-Week Academy, please identify below which program you would like to attend for each week. If you have any questions, please contact us at 800.533.7371. Type any comments in the field below: Please Note: After submitting this application the SoccerPlus Office Staff must process your information before the student is enrolled in camp.  You will be directed to a receipt/page of your application.