2017 lightning boys' goalkeeper summer camp
Attn: Ryan Dixon Goldey-Beacom College Athletics 4701 Limestone Road Wilmington, DE 19808
GENERAL RELEASE
July 24-27, 2017 Nancy Churchman Sawin Field Goldey-Beacom College Campus • Wilmington, DE
Please return to: Ryan Dixon, Goldey-Beacom College Athletics, 4701 Limestone Road, Wilmington, DE 19808
Emergency Phone Number: __________________________ Relationship: ___________________
Parent/Guardian Signature: ________________________________________ Date: ____________________
As a parent/guardian of the registered child, I certify that he/she is in excellent physical health and capable of participation in strenuous activity. I hearby give my approval for his/her participation in the Goldey-Beacom College Boys’ Goalkeeper Summer Camp. In case of injury to my child, I agree to waive all claims resulting from or in connection with the activities in which my child is a participant. I hereby release, absolve, and hold harmless the GoldeyBeacom College Boy’s Soccer Goalkeeper Camp, coaches, directors and administrators. I also agree that any pictures taken of the registered child can be used by Goldey-Beacom College for publicity purposes.
2017 LIGHTNING BOYS’ GOALKEEPER SUMMER CAMP
With club and high school season around the corner, Goldey-Beacom Men’s Soccer is offering a chance to get a jump on your preseason training. Each session will both be technically and tactically challenging while also providing constant feedback. The training sessions will be the same we run with our players during the season, but geared specifically to the age and developmental level of the keeper. MONDAY-THURSDAY, JULY 24-27 5:00-7:00 PM Fee: $60 • Ages: 13-16
Please fill out all information and please do not forget to sign the general-release waiver. An athletic trainer will be on site during the camp.
PLEASE BRING
• Water or sports drink • Everything to play outside (gloves, cleats, long-sleeve top, etc...) • Running shoes (camp will be moved inside in case of bad weather)
CAMP DIRECTOR
Ryan Dixon Head Men’s Soccer Coach
2017 CAMP APPLICATION Day Camp Tuition: $60.00 Team and group requests must be submitted in written form. We will
• Entering his sixth season as attempt to honor all requests. Make checks payable to Goldey-Beacom Goldey-Beacom head coach. College, 4701 Limestone Road, Wilmington, DE 19808. • Led Goldey-Beacom to the CACC Tournament each of the last two Check all of the sessions you wish to attend: seasons. • Played goalkeeper four seasons Total (2000-03) at Rowan, leading it to July 24-27 _____ the 2000 NCAA final. • Has his USSF National “D” License and a goalkeeping Level “3” Diploma from the National Soccer Coaches Association of America. Camper’s Name: _________________________________________
CAMP GOALS
• Get you ready for preseason • High-level training atmosphere • Designed for goalkeepers who want to solidify and sharpen their technique • Small-group environment (fewer goalkeepers means more repetitions • We will cover every aspect of the position, physical work and technical/tactical work on the field
Address: _______________________________________________ City: ______________________ State: _______ Zip: _____________ Home Phone: ____________________ Age: _____ DOB: ___________ Grade (Fall 2017): __________ School: __________________________ E-Mail Address: ___________________________________________
Camper’s Health Record Emergency Information Mother’s Name: ______________________ Phone: ________________ Father’s Name: ______________________ Phone: ________________ Emergency Contact: _____________________ Phone: ______________ Insurance Company: ________________________________________ Policy #: _______________________________________________ Policyholder’s Name: _______________________________________ Primary Care Physician: ______________________________________ Phone: ________________________________________________ Please list any current medications, allergies, surgeries, physical restrictions or chronic/recurring illnesses. ____________________________________________________
Please sign the release on the back page.
GENERAL RELEASE
July 24-27, 2017 Nancy Churchman Sawin Field Goldey-Beacom College Campus • Wilmington, DE
Please return to: Ryan Dixon, Goldey-Beacom College Athletics, 4701 Limestone Road, Wilmington, DE 19808
Emergency Phone Number: __________________________ Relationship: ___________________
Parent/Guardian Signature: ________________________________________ Date: ____________________
As a parent/guardian of the registered child, I certify that he/she is in excellent physical health and capable of participation in strenuous activity. I hearby give my approval for his/her participation in the Goldey-Beacom College Boys’ Goalkeeper Summer Camp. In case of injury to my child, I agree to waive all claims resulting from or in connection with the activities in which my child is a participant. I hereby release, absolve, and hold harmless the GoldeyBeacom College Boy’s Soccer Goalkeeper Camp, coaches, directors and administrators. I also agree that any pictures taken of the registered child can be used by Goldey-Beacom College for publicity purposes.
2017 LIGHTNING BOYS’ GOALKEEPER SUMMER CAMP
With club and high school season around the corner, Goldey-Beacom Men’s Soccer is offering a chance to get a jump on your preseason training. Each session will both be technically and tactically challenging while also providing constant feedback. The training sessions will be the same we run with our players during the season, but geared specifically to the age and developmental level of the keeper. MONDAY-THURSDAY, JULY 24-27 5:00-7:00 PM Fee: $60 • Ages: 13-16
Please fill out all information and please do not forget to sign the general-release waiver. An athletic trainer will be on site during the camp.
PLEASE BRING
• Water or sports drink • Everything to play outside (gloves, cleats, long-sleeve top, etc...) • Running shoes (camp will be moved inside in case of bad weather)
CAMP DIRECTOR
Ryan Dixon Head Men’s Soccer Coach
2017 CAMP APPLICATION Day Camp Tuition: $60.00 Team and group requests must be submitted in written form. We will
• Entering his sixth season as attempt to honor all requests. Make checks payable to Goldey-Beacom Goldey-Beacom head coach. College, 4701 Limestone Road, Wilmington, DE 19808. • Led Goldey-Beacom to the CACC Tournament each of the last two Check all of the sessions you wish to attend: seasons. • Played goalkeeper four seasons Total (2000-03) at Rowan, leading it to July 24-27 _____ the 2000 NCAA final. • Has his USSF National “D” License and a goalkeeping Level “3” Diploma from the National Soccer Coaches Association of America. Camper’s Name: _________________________________________
CAMP GOALS
• Get you ready for preseason • High-level training atmosphere • Designed for goalkeepers who want to solidify and sharpen their technique • Small-group environment (fewer goalkeepers means more repetitions • We will cover every aspect of the position, physical work and technical/tactical work on the field
Address: _______________________________________________ City: ______________________ State: _______ Zip: _____________ Home Phone: ____________________ Age: _____ DOB: ___________ Grade (Fall 2017): __________ School: __________________________ E-Mail Address: ___________________________________________
Camper’s Health Record Emergency Information Mother’s Name: ______________________ Phone: ________________ Father’s Name: ______________________ Phone: ________________ Emergency Contact: _____________________ Phone: ______________ Insurance Company: ________________________________________ Policy #: _______________________________________________ Policyholder’s Name: _______________________________________ Primary Care Physician: ______________________________________ Phone: ________________________________________________ Please list any current medications, allergies, surgeries, physical restrictions or chronic/recurring illnesses. ____________________________________________________
Please sign the release on the back page.
