Coastal Carolina Soccer Camp

Please complete the full application below. By paying through our secured on-line system you will pay your complete camp fees. You can also choose to pay a $200 camp deposit and your final payment at registration first day of camp. Visa or MasterCard accepted. Use designated area below for charges. You must include your coaches email address if you are part of a team that is attending. Please make sure you read the acceptance letter on our website page and follow all instructions. Thank you.

* denotes required field

Each Session requires one application

Advanced Camp for Full and Partial Teams

$469

Advanced Camp for Individual Field Players

$469

Advanced Keeper Academy

$469

Elite Field Players Academy

$559

Elite Keeper Academy

$559

Striker/Attackers Camp for Individual Players

$469

Striker/Attackers Camp for Full and Partial Teams

$469

Developing Youth Team Camp for only Full Teams

$469

Additional Coaches or Individual Coach Auditing

$250

PARENTAL CONSENT FORM: I/We the undersigned certify that we are the parents/legal guardian of the player. We give permission for the staff of CCSCA to seek, during the period of this program, appropriate medical attention for the player in the event of accident, injury, or illness. We will be responsible for any and all costs of medical attention and treatment, except for that covered by this program�s excess medical coverage policy. I/We, the undersigned, for ourselves and as guardian(s) of player�s name understand that soccer is an active, physical sport and that injuries can take place during play. We also understand that there will be a number of players attending this program, that there will be a limited number of coaches, staff, and counselors, and that our child cannot receive individualized attention and supervision all of the time. We understand that, as with any sport, injuries can occur and hereby acknowledge that our child is physically and mentally capable of participating in the program�s activities. We will not hold this program responsible for any preexisting injuries or recurrence of any undisclosed preexisting injury or illness of our child prior to the first day of camp. We represent that we have sought the opinion of our child�s physician, and he/she concurs that the camper is fully capable of safely engaging in this sport. We, the undersigned, for ourselves, our heirs, executors, and administrators, waive, release, and forever discharge Paul Banta, CCSCA , and it�s staff, offices, agents, employees, representatives, and successors and assign of and from all rights and claims for damages, injury or loss to person or property which may be sustained or occur during participation in this programs activities or while at the program, whether or not damages, injuries or loss is due to negligence.

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Paul Banta's Coastal Carolina Soccer Camp Paul Banta's Coastal Carolina Soccer Camp Paul Banta's Coastal Carolina Soccer Camp Paul Banta's Coastal Carolina Soccer Camp Paul Banta's Coastal Carolina Soccer Camp Paul Banta's 2010 Coastal Carolina Soccer Camp Paul Banta's 2010 Coastal Carolina Soccer Camp Paul Banta's 2010 Coastal Carolina Soccer Camp Paul Banta's 2010 Coastal Carolina Soccer Camp Paul Banta's 2010 Coastal Carolina Soccer Camp Paul Banta's 2010 Coastal Carolina Soccer Camp 2010 Coastal Carolina Soccer Camp 2010 Coastal Carolina Soccer Camp 2010 Coastal Carolina Soccer Camp 2010 Coastal Carolina Soccer Camp 2010 Coastal Carolina Soccer Camp 12th Annual Coastal Carolina Striker Camps 12th Annual Coastal Carolina Striker Camps 12th Annual Coastal Carolina Striker Camps 12th Annual Coastal Carolina Striker Camps 12th Annual Coastal Carolina Striker Camps 12th Annual Coastal Carolina Striker Camps 12th Annual Striker Camps 12th Annual Striker Camps 12th Annual Striker Camps 12th Annual Striker Camps 12th Annual Striker Camps 12th Annual Striker Camps #1 Southern Soccer Camp #1 Southern Soccer Camp #1 Southern Soccer Camp #1 Southern Soccer Camp #1 Southern Soccer Camp #1 Southern Soccer Camp Soccer Camps in Georgia Soccer Camps in Georgia Soccer Camps in Georgia Soccer Camps in Georgia Soccer Camps in Georgia Soccer Camps in Georgia soccer camps soccer camps soccer camps soccer camps soccer camps soccer camps soccer camps soccer camp soccer camp soccer camp soccer camp soccer camp soccer camp Team Camp Soccer Team Camp Soccer Team Camp Soccer Team Camp Soccer Team Camp Soccer Team Camp Soccer Team soccer camp Team soccer camp Team soccer camp Team soccer camp Team soccer camp goalkeeper camps goalkeeper camps goalkeeper camps goalkeeper camps goalkeeper camps goalkeeper camps striker camps striker camps striker camps striker camps striker camps striker camps summer soccer camps summer soccer camps summer soccer camps summer soccer camps summer soccer 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Soccer Camp Coastal Carolina Soccer Camp Advanced Goalkeeper Soccer Camp Georgia Advanced Goalkeeper Soccer Camp Georgia Advanced Goalkeeper Soccer Camp Georgia Advanced Goalkeeper Soccer Camp Georgia Advanced Goalkeeper Soccer Camp Georgia Advanced Goalkeeper Soccer Camp fl Advanced Goalkeeper Soccer Camp fl Advanced Goalkeeper Soccer Camp fl Advanced Goalkeeper Soccer Camp fl Advanced Goalkeeper Soccer Camp fl Advanced Goalkeeper Soccer Camp sc Advanced Goalkeeper Soccer Camp sc Advanced Goalkeeper Soccer Camp sc Advanced Goalkeeper Soccer Camp sc Advanced Goalkeeper Soccer Camp sc Advanced Goalkeeper Soccer Camp al Advanced Goalkeeper Soccer Camp al Advanced Goalkeeper Soccer Camp al Advanced Goalkeeper Soccer Camp al Advanced Goalkeeper Soccer Camp al Advanced Goalkeeper Soccer Camp tn Advanced Goalkeeper Soccer Camp tn Advanced Goalkeeper Soccer Camp tn Advanced Goalkeeper Soccer Camp tn Advanced Goalkeeper Soccer Camp tn Advanced Goalkeeper Soccer Camp nc Advanced Goalkeeper Soccer Camp nc Advanced Goalkeeper Soccer Camp nc Advanced Goalkeeper Soccer Camp nc Advanced Goalkeeper Soccer Camp nc Advanced Goalkeeper Soccer Camp ky Advanced Goalkeeper Soccer Camp ky Advanced Goalkeeper Soccer Camp ky Advanced Goalkeeper Soccer Camp ky Advanced Goalkeeper Soccer Camp ky Advanced Goalkeeper Soccer Camp va Advanced Goalkeeper Soccer Camp va Advanced Goalkeeper Soccer Camp va Advanced Goalkeeper Soccer Camp va Advanced Goalkeeper Soccer Camp va Elite Goalkeeper Soccer Camp Georgia Elite Goalkeeper Soccer Camp Georgia Elite Goalkeeper Soccer Camp Georgia Elite Goalkeeper Soccer Camp Georgia Elite Goalkeeper Soccer Camp Tennessee Elite Goalkeeper Soccer Camp Tennessee Elite Goalkeeper Soccer Camp Tennessee Elite Goalkeeper Soccer Camp Tennessee Elite Goalkeeper Soccer Camp Alabama Elite Goalkeeper Soccer Camp Alabama Elite Goalkeeper Soccer Camp Alabama Elite Goalkeeper Soccer Camp Alabama Elite Goalkeeper Soccer Camp Kentucky Elite Goalkeeper Soccer Camp Kentucky Elite Goalkeeper Soccer Camp Kentucky Elite Goalkeeper Soccer Camp Kentucky Elite Goalkeeper Soccer Camp South Carolina Elite Goalkeeper Soccer Camp South Carolina Elite Goalkeeper Soccer Camp South Carolina Elite Goalkeeper Soccer Camp South Carolina Elite Goalkeeper Soccer Camp North Carolina Elite Goalkeeper Soccer Camp North Carolina Elite Goalkeeper Soccer Camp North Carolina Elite Goalkeeper Soccer Camp North Carolina Elite Goalkeeper Soccer Camp Virginia Elite Goalkeeper Soccer Camp Virginia Elite Goalkeeper Soccer Camp Virginia Elite Goalkeeper Soccer Camp Virginia Elite Goalkeeper Soccer Camp Florida Elite Goalkeeper Soccer Camp Florida Elite Goalkeeper Soccer Camp Florida Elite Goalkeeper Soccer Camp Florida Goalkeeper Academy Soccer Camp Georgia Goalkeeper Academy Soccer Camp Georgia Goalkeeper Academy Soccer Camp Georgia Goalkeeper Academy Soccer Camp Georgia Goalkeeper Academy Soccer Camp Tennessee Goalkeeper Academy Soccer Camp Tennessee Goalkeeper Academy Soccer Camp 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Camp Virginia Goalkeeper Academy Soccer Camp Virginia Nationally Goalkeeping Training Center GA Nationally Goalkeeping Training Center GA Nationally Goalkeeping Training Center GA Nationally Goalkeeping Training Center GA Nationally Goalkeeping Training Center FL Nationally Goalkeeping Training Center FL Nationally Goalkeeping Training Center FL Nationally Goalkeeping Training Center FL Nationally Goalkeeping Training Center AL Nationally Goalkeeping Training Center AL Nationally Goalkeeping Training Center AL Nationally Goalkeeping Training Center AL Nationally Goalkeeping Training Center TN Nationally Goalkeeping Training Center TN Nationally Goalkeeping Training Center TN Nationally Goalkeeping Training Center TN Nationally Goalkeeping Training Center SC Nationally Goalkeeping Training Center SC Nationally Goalkeeping Training Center SC Nationally Goalkeeping Training Center SC Nationally Goalkeeping Training Center NC Nationally Goalkeeping Training Center NC Nationally Goalkeeping Training Center NC Nationally Goalkeeping Training Center NC Nationally Goalkeeping Training Center KY Nationally Goalkeeping Training Center KY Nationally Goalkeeping Training Center KY Nationally Goalkeeping Training Center KY Nationally Goalkeeping Training Center VA Nationally Goalkeeping Training Center VA Nationally Goalkeeping Training Center VA Nationally Goalkeeping Training Center VA Striker Camp Georgia Striker Camp Georgia Striker Camp Georgia Striker Camp Georgia Striker soccer Camp Georgia Striker soccer Camp Georgia Striker soccer Camp Georgia Striker soccer Camp Georgia Striker soccer Camp Georgia Striker Camp Tennessee Striker Camp Tennessee Striker Camp Tennessee Striker Camp Tennessee Striker soccer Camp Florida Striker soccer Camp Florida Striker soccer Camp Florida Striker soccer Camp Florida Striker Camp Alabama Striker Camp Alabama Striker Camp Alabama Striker Camp Alabama Striker soccer Camp Alabama Striker soccer Camp Alabama Striker soccer Camp Alabama Striker soccer Camp Alabama Striker Camp South Carolina Striker Camp South Carolina Striker Camp South Carolina Striker Camp South Carolina Striker Soccer Camp South Carolina Striker Soccer Camp South Carolina Striker Soccer Camp South Carolina Striker Soccer Camp South Carolina Striker Soccer Camp North Carolina Striker Soccer Camp North Carolina Striker Soccer Camp North Carolina Striker Soccer Camp North Carolina Striker Camp North Carolina Striker Camp North Carolina Striker Camp North Carolina Striker Camp North Carolina Striker Soccer Camp Virginia Striker Soccer Camp Virginia Striker Soccer Camp Virginia Striker Soccer Camp Virginia Striker Camp Virginia Striker Camp Virginia Striker Camp Virginia Striker Camp Virginia Striker Soccer Camp Kentucky Striker Soccer Camp Kentucky Striker Soccer Camp Kentucky Striker Soccer Camp Kentucky Striker Camp Kentucky Striker Camp Kentucky Striker Camp Kentucky Striker Camp Kentucky Soccer Team Camps Georgia Soccer Team Camps Georgia Soccer Team 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Team Camps Georgia High School Soccer Team Camps Georgia High School Soccer Team Camps Florida High School Soccer Team Camps Florida High School Soccer Team Camps Florida High School Soccer Team Camps Florida High School Soccer Team Camps Tennessee High School Soccer Team Camps Tennessee High School Soccer Team Camps Tennessee High School Soccer Team Camps Tennessee High School Soccer Team Camps Alabama High School Soccer Team Camps Alabama High School Soccer Team Camps Alabama High School Soccer Team Camps Alabama High School Soccer Team Camps Kentucky High School Soccer Team Camps Kentucky High School Soccer Team Camps Kentucky High School Soccer Team Camps Kentucky High School Soccer Team Camps South Carolina High School Soccer Team Camps South Carolina High School Soccer Team Camps South Carolina High School Soccer Team Camps South Carolina High School Soccer Team Camps North Carolina High School Soccer Team Camps North Carolina High School Soccer Team Camps North Carolina High School Soccer Team Camps North Carolina High School Soccer Team Camps Virginia High School Soccer Team Camps Virginia High School Soccer Team Camps Virginia High School Soccer Team Camps Virginia 2009 Paul Banta's Coastal Carolina Soccer Camp Georgia 2009 Paul Banta's Coastal Carolina Soccer Camp Georgia 2009 Paul Banta's Coastal Carolina Soccer Camp Georgia 2009 Paul Banta's Coastal Carolina Soccer Camp Georgia 2009 Paul Banta's Coastal Carolina Soccer Camp Florida 2009 Paul Banta's Coastal Carolina Soccer Camp Florida 2009 Paul Banta's Coastal Carolina Soccer Camp Florida 2009 Paul Banta's Coastal Carolina Soccer Camp Florida 2009 Paul Banta's Coastal Carolina Soccer Camp Alabama 2009 Paul Banta's Coastal Carolina Soccer Camp Alabama 2009 Paul Banta's Coastal Carolina Soccer Camp Alabama 2009 Paul Banta's Coastal Carolina Soccer Camp Alabama 2009 Paul Banta's Coastal Carolina Soccer Camp Tennessee 2009 Paul Banta's Coastal Carolina Soccer Camp Tennessee 2009 Paul Banta's Coastal Carolina Soccer Camp Tennessee 2009 Paul Banta's Coastal Carolina Soccer Camp Tennessee 2009 Paul Banta's Coastal Carolina Soccer Camp Kentucky 2009 Paul Banta's Coastal Carolina Soccer Camp Kentucky 2009 Paul Banta's Coastal Carolina Soccer Camp Kentucky 2009 Paul Banta's Coastal Carolina Soccer Camp Kentucky 2009 Paul Banta's Coastal Carolina Soccer Camp South Carolina 2009 Paul Banta's Coastal Carolina Soccer Camp South Carolina 2009 Paul Banta's Coastal Carolina Soccer Camp South Carolina 2009 Paul Banta's Coastal Carolina Soccer Camp South Carolina 2009 Paul Banta's Coastal Carolina Soccer Camp North Carolina 2009 Paul Banta's Coastal Carolina Soccer Camp North Carolina 2009 Paul Banta's Coastal Carolina Soccer Camp North Carolina 2009 Paul Banta's Coastal Carolina Soccer Camp North Carolina 2009 Paul Banta's Coastal Carolina Soccer Camp Virginia 2009 Paul Banta's Coastal Carolina Soccer Camp Virginia 2009 Paul Banta's Coastal Carolina Soccer Camp Virginia 2009 Paul Banta's 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