Summer Camp
Pre-Registration
Pre-registration Form
 Today's
Date
Summer Camp
Heritage Isles
June 14  - June 18
 Aug. 2 - Aug. 6
July 5 - July 9
Grand Hamptons
Aug. 9 - Aug. 13
July 12 - July 16
June 21 - June 25
Seven Oaks
July 19 - July 23
June 28 - July 2
July 26 - July 30
Please complete the following application. Do not leave any space blank. If a space does
not apply to you please enter N/A. Thank you.
2010 Summer Camp
Parents Name
Email        example tom@aol.com
Last
 First
Parents Name
Email        example tom@aol.com
Last
 First
Child's Name
 Age
Last
 First
Age
Last
 First
Age
Last
 First
Age
Last
 First
Address
Street
 City
State
Zip
Phone
Work
Home
 Cell
Area Code
 Area Code
 Area Code
Emergency
Contact
Home
Area Code
Last
 First
Someone other than yourself we can contact in case of emergency.
Child's shirt size
 Child's shirt size
YL
S
M
L
XL
XXL
Child's shirt size
 YL
S
M
L
XL
XXL
 YL
S
M
L
XL
XXL
Child's shirt size
YL
S
M
L
XL
XXL
Upon completion of this application a $170.00 deposit is required to
register your child. ($120.00 weekly rate and $50.00 registration
fee) This will guarantee your discount and secure your child's spot.
Please send check or money order to:               
                            
Make check payable to:     PROtential Sports
       19046 Bruce B Downs Suite 83
       Tampa FL 33647

Or pay with Credit Card after submitting information
Please review your
answers and make
sure every space is
filled. Then submit.
2010
Please check the weeks your child will be attending. The registration system is based on a first come first serve basis
with limited space available. Please check all weeks your child will be attending. Thank You
Sports Summer Camp
Monday -Friday 9am to 5pm
7am to 9am & 5pm to 6:00pm
(requires extra fee)
Does not require Field Trips