P.O. Box 895 Lafayette, CO 80026 
Jude 303-665-2621
2001 TREBOL SOCCER CAMP
June 11-14, 4-6 pm at Centaurus High School

                         Iím applying to the: goalie camp (ages 11-18) featuring David Kramer ____________ 

                       Competitive camp (ages 11-18) featuring Paul Bravo__________
                          Developmental camp (ages 7-11) featuring Marcelo Balboa _____



Player Name _________________________            Birthdate __________________
Address _____________________________           Current Age _______________
City/Zip _____________________________           Phone ____________________

Are you playing with a Trebol team in the fall?  Yes   No 
             If yes, with which team? _______________
             If no, with which club/team are you playing? ____________________
   Shirt:: Youth-  S   M   L     Adult- S   M   L   XL

Parent Name(s) _________________________________________________________
Day Phone (Dad) ___________________        (Mom) ___________________________
Eve. Phone (Dad) ___________________        (Mom)___________________________

WAIVER AND ASSUMPTION OF RISK

I HEREBY EXEMPT AND RELEASE TREBOL SOCCER CLUB OF LAFAYETTE, INC. CENTARUS HIGH SCHOOL, THE COLORADO RAPIDS AND ITS REPRESENTATIVES FROM ANY AND ALL LIABILITY, CLAIMS, DEMANDS OR ACTIONS OR CAUSES OF ACTION WHATSOEVER ARISING OUT OF ANY DAMAGE, LOSS OR INJURY TO MY CHILD OR MY CHILDíS PROPERTY WHILE PARTICIPATING IN ANY OF THE ACTIVITIES CONTEMPLATED BY THIS AGREEMENT, WHETHER SUCH LOSS, DAMAGE, OR INJURY RESULTS FROM THE NEGLIGENCE OF THE TREBOL SOCCER CLUB OF LAFAYETTE, INC. OR ITS REPRESENTATIVES OR FROM SOME OTHER CAUSE. I FURTHER AUTHORIZE THE AGENTS OR EMPLOYEES OF THE TREBOL SOCCER CLUB OF LAFAYETTE, INC. TO ACT ACCORDING TO THEIR BEST JUDGMENT IN AN EMERGENCY REQUIRING MEDICAL ATTENTION. 
___________________________________         ______________________
(Signature of parent or guardian)                                            (Date)

Each soccer player in the camp will also receive a t-shirt and a ticket for a Rapids game. Parents and family members may purchase extra tickets for $10 each. Additional information about ticket distribution will be given at the 1st day of camp.

I would like to order additional __________ tickets for the game!
The cost of the goalie and competitive camps is $125, the developmental is $85. Payment must be included with the application. Make checks out to Trebol Soccer Club.