2006 SSU- HOEK CAMP APPLICATION
Camp Dates: June 18-22
Camper Name ________________________
D.O.B._____________________
Age_______________
Parent Name___________________________ Position______________ Circle: Male / Female
Street_________________________________ City_______________ State_______________
Zip________ E-Mail__________________ Commuter _____ Residential ______ (check one)
Phone # ____________________________ Emergency Contact # __________________________
T-Shirt Sizes: YL_____ AS_____ AM_____ AL_____ AXL_____
Requested Roommate _____________________________________________

Camp Fee: $695 for Residential
$525 for Commuter
$200 deposit due with application ...remaining balance due by June 1st
Amount Enclosed $___________________ Check #__________________ (Make checks payable to SSU Soccer)
Charge to my credit card the amount of $______________________
For Credit Card Payments only, you may fax registration to (707) 664-2200
Card#________________________________________________ Exp Date________________
Circle One: VISA ............MC...........AMEX
Cardholder Name__________________________________________________________
CardHolder Signature_______________________________________________________

Check Return Policy: If your check is returned for insufficient funds there will be an additional $25 charge.
Cancellation Policy: If for any reason you need to cancel your reservation within 30 days prior to the start of the camp, you have a choice of receiving a full refund, less a $35 administrative fee, or a camp/tournament credit for the full amount that you paid.

MAIL WITH PAYMENT TO:
SSU Soccer – Hoek Camp
1801 E. Cotati Ave.
Rohnert Park, CA 94928