Field Hockey Camp On-Line Registration

Langley Field Hockey On-Line Camp Registration
June 17 - 21, 2019 (Grades 1 - 8)

* Indicates required field

CAMPER'S NAME (not parent) *

First

Last

Email *

Address *

Line 1

Line 2

City

State

Zip Code

Country

Phone Number *

Gender *

Camper Grade (2018-19 School Year) *

Shirt Size (Adult sizes) *

Please list any medical conditions the staff needs to be aware of during camp. *

I hereby state that my child is in good health and has my permission to participate in all activities. I authorize Langley Volleyball staff to authorize emergency first aid in the event of sickness or injury. My signature below releases the camp, sponsors, staff, and director from any and all liability.

Parent or Guardian initials releasing liability *

Submit and Proceed to Online Payment Option

If you do not complete the payment online,
please send a check to
Langley Field Hockey Youth Camp c/o Beth Longo
Langley High School
6520 Georgetown Pike
McLean, VA 22101