2018/2019 Commitment Fee
2018 July Payment

Camp Registration 2018


Location: Long Island University
Time: 9AM – 3PM

Child’s Name *

Year of Birth *

Address *

Current Team

Shirt Size *


Parent Information *

Parental Release *

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