Complete this form and
sign informed consent
for disclosure of personal information to book your Milan Junior Camp
(*) Obligatory fields
Name
*
Surname
*
Sex
*
Seleziona - Select
Height (cm)
*
Weight (Kg)
*
Street
*
Number
*
Code
*
City
*
Province
*
Ceck if outside Italy
State
*
Telephone
*
Fax
Cellular phone
*
Date of birth (dd/mm/year)
*
Parent's name
*
Parent's surname
*
Soccer club
Boy's e-mail
*
Parent's e-mail
*
Soccer role
*
Seleziona - Select
Discount
*
Seleziona - Only for Italians
Camp Formula
*
Seleziona - Select
Camp
*
(you can select more than a week)
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