Application

Mail application, along with non-refundable deposit of $25.00 to:

Lyon College

Soccer Camp Director

P.O. Box 2317

Batesville, AR 72503

Make checks payable to Lyon College Soccer

$65 per camper

$70 after June 1

                *****Please Print*****

Name__________________________________________________

Address________________________________________________

City & State_____________________________________________

Zip_______________ Age _______________________

Telephone: (Home)________________________________________

        (Emergency)_________________________________________

E-Mail_________________________________________________

T-Shirt Size -  (circle one)    YS    YM    YL      S        M        L        XL

School_________________________________________________

Parents_________________________________________________