2008 Application Form
Pioneers Professional Soccer Camp
To reserve your spot at camp, please print and then send this application along with payment in full or a non-refundable $50.00 deposit to:

Western Mass Pioneers
P.O. Box 457
Ludlow MA 01056
Tel: (413) 583-4814

Name_______________________________________

Address_____________________________________

City__________________State______Zip_________

Phone__________________________Age_________

Emergency Phone_____________________________

E-Mail_____________________________

Field Player _________ Goalkeeper_________

Please circle T-shirt size : YL AS AM AL AXL

Ludlow: Lusitano Stadium

June 23-27 / July 7-11 / July 21-25

Aug 13-17 (High School prep weeks, ages 13-18, 5-7 PM, $99)

1/2 Day - 120.00____**** Full Day 185.00_______

(please circle desired camp dates)

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