Semet Retires from AC Soccer

Thanks to everyone for such great support through the years. As of Jan. 1, 2011 I am retired from coaching the AC Soccer team. I will be coaching my daughters now & spending more time with my family. Thanks for the memories!

Please Print/Mail to address below:
Camp dates(s) ____________________________________________________________________________

Camper’s Name: _____________________________________________________________________________

Street Address: ____________________________________________________________________________

City/State/Zip: ______________________________________________________________________________

Email: _____________________________________Shirt:_________

H. Phone:____________Cell_______________ Parent/Guardian: _______________________

Camper’s Age: ________________ D.O.B. : ___________________

Medical Concerns/Allergies:_________________________ Insurance:___________________________

Parent/Guardian Signature: _____________________________________________________________________

Waiver/Release: I hereby represent that my child has been examined by a doctor and that they are physically fit to participate in the Semet Shore Viking Soccer Camps. I understand there are inherent risks in participating in this athletic camp. I hereby accept responsibility for and agree to pay any and all costs of medical treatment resulting from any injury suffered to me in my participation at the Viking Soccer Camps. I further agree to indemnify and hold harmless Semet Shore Viking Soccer Camps, Atlantic Christian School, City of Brigantine, Ventnor or Margate, its employees and/or representatives from any and all liability, damage, cost or expense arising out of my participation, of every kind and nature, at Shore Viking Soccer Camps.

Please make Check Payable to: Kevin Semet
Mail to: Kevin Semet/Shore Viking Soccer
504 Cape Island Court
Egg Harbor Twp., NJ 08234
or Recreation Department