Fall Season
$0.00
Location: Long Island University Time: 9AM – 3PM
First Name
Last Name
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Street Address
City
State
Select an option... YXS YS YM YL AS AM AL AXL
Session 1 – Long Island University June 25th to 29th – 9AM til 3PM ($399.00)
Session 2 – Long Island University July 9th to 13th – 9AM til 3PM ($399.00)
Session 3 – Long Island University July 23rd to 27th – 9AM til 3PM ($399.00)
Session 4 – Long Island University August 6th to 10th – 9AM til 3PM ($399.00)
All 4 Sessions – Includes all of the above ($1,149.00)
Name
Cell Phone
Emergency Contact
Email
This is to certify that my son/daughter has permission to participate in any and all camp activities. I assume all risks and hazards incidental to such participation and I do hereby agree to hold harmless the staff of the Valencia CF Academy NY from any and all claims arising out of any injury to my child. Furthermore, this verifies that the camper is up to date with his/her immunizations and is able to participate in all camp activities. In the event of injury my permission is granted for treatment as required at the nearest medical treatment facility. I also give permission for any images of my child to be used for promotional purposes
I agree
