Georgetown International Youth Soccer
Choose a Camp:

Bethesda
St. Bartholomew School, 6900 River Road, Bethesda, MD

Dates   Half-day
9–12
Full-day
9–4
June 16–20 Beginner to Intermediate Program Sold Out
  Elite Program Sold Out
June 23–27 Beginner to Intermediate Program Sold Out
  Elite Program Sold Out
June 30–July 4 Beginner to Intermediate Program
  Elite Program
    Beg/Int:
$191/Week
Elite:
$204/Week
Beg/Int:
$281/Week
Elite:
$314/Week
Check here if you need transportation ($50.00/Per Week)
Pickup is from the Lafayette School in Chevy Chase,
the Sidwell Friends School, and River Road.
Camper and Family Information:

Camper’s Name

Camper’s Date of Birth

Gender: Male Female

Camper’s School

GIYS Camps Previously Attended

Soccer Positions

Camper’s Allergies/Conditions

Parents’ and/or Guardians’ First and Last Name

Home Address

E-mail address

Home Phone Number

Cell Phone Number

Coach's Name

Coach's Email

Emergency Contact Name (other than parents)

Contact’s Relationship

Contact’s Phone Number

Child's Physician

Physician’s Phone Number

Health Insurance Carrier

Insurance Policy/Group Number

Parental Permission and Release Statement:

The parent or guardian of the camper must read, understand, and agree to the following statements:

The parent or guardian must enter their name and the date below to indicate their agreement with the preceeding statements:

Name of Parent Guardian

Date

Payment:

Be sure to submit your payment as soon as possible, by any of the following methods. Included in all fees is a non-refundable $25.00 application fee.


Paying by Check:
Make check payable to "GIYS". Be sure to write the camper's entire name on the check, and send it to us via US Mail.

Check #

Amount

Print this completed appliction, and send it along with your payment to:
Georgetown International Soccer
ATTN: Zaki Hamzaoui
PO Box 9862
Washington, DC 20016


Pay by Paypal:

If you wish to pay immediatly online, there will be directions on the following page that explain how to send us your payment via the online service PayPal. (Note: If you are paying online, there is a 4% processing fee.)

Additional:

How did you hear about us? (required)

Finish: