ELITE PLAYER CLINIC
ELITE PLAYER CLINIC August 3, 2013 The clinic is designed to provide all High School aged (14-18) men’s soccer players with an elite level college training experience lead by current college coaches and assisted by current college players in order to allow each participant the opportunity to experience a day in the life of a Division I college soccer player!
INCLUDED… 70 minute Training Session 30 minute speed & agility session Iona College Campus Tour Afternoon Matches Assistant Director: Donnie Hathorn Iona College Asst. Coach
CLINIC DIRECTOR: Fernando Barboto Iona College Head Coach
Guest Instructor: Kelly Schaver Iona College Strength Coach
August 3rd from 10am – 3pm (Check-In begins at 9:15am) Iona College Campus: 715 North Avenue. New Rochelle, NY 10801 Drop-off & Pick-up @ Mazella Field across from Hynes Athletic Center Cost per Session: $99 AGES 14-18 Check or Money Order made payable to: Fernando Barboto Mail to: Fernando Barboto, Hynes Atletic Center, 715 North Ave. New Rochelle, NY 10801 Contact information: 914-633-2315 or email Fernando Barboto at [email protected] Name: _______________________________________
Address: ________________________________________________
City: ________________________________ State: ______ Zip: __________ Home Phone: _______________________________ Cell: ______________________________ Date of Birth: ______ / ______ / ______ High School Grad Year: ___________ Do you play club soccer? Y N
Age: _____________ Email (required) - _________________________________ High School: ______________________________________
Team: ________________________________________________
Waiver Release: MY son is in good health and has my full permission to participate in a rigorous soccer program. My son has no previous sickness, illness, disease or bodily injury that is contradictory to participation. I fully understand that soccer is a rigorous sport and that physical injury may occur during the course of practice and games. In the event that I cannot be reached, I give my full permission for such medical procedures as may be deemed necessary by an examining physician. I also understand that Iona College is not responsible for injury or the loss of any personal items. Applicant’s Name: _____________________________________ Date: ____________________ Parent/Guardian Signature: ________________________________ Date: ___________________ Health Insurance: ________________________________________ Claim # - _______________
INCLUDED… 70 minute Training Session 30 minute speed & agility session Iona College Campus Tour Afternoon Matches Assistant Director: Donnie Hathorn Iona College Asst. Coach
CLINIC DIRECTOR: Fernando Barboto Iona College Head Coach
Guest Instructor: Kelly Schaver Iona College Strength Coach
August 3rd from 10am – 3pm (Check-In begins at 9:15am) Iona College Campus: 715 North Avenue. New Rochelle, NY 10801 Drop-off & Pick-up @ Mazella Field across from Hynes Athletic Center Cost per Session: $99 AGES 14-18 Check or Money Order made payable to: Fernando Barboto Mail to: Fernando Barboto, Hynes Atletic Center, 715 North Ave. New Rochelle, NY 10801 Contact information: 914-633-2315 or email Fernando Barboto at [email protected] Name: _______________________________________
Address: ________________________________________________
City: ________________________________ State: ______ Zip: __________ Home Phone: _______________________________ Cell: ______________________________ Date of Birth: ______ / ______ / ______ High School Grad Year: ___________ Do you play club soccer? Y N
Age: _____________ Email (required) - _________________________________ High School: ______________________________________
Team: ________________________________________________
Waiver Release: MY son is in good health and has my full permission to participate in a rigorous soccer program. My son has no previous sickness, illness, disease or bodily injury that is contradictory to participation. I fully understand that soccer is a rigorous sport and that physical injury may occur during the course of practice and games. In the event that I cannot be reached, I give my full permission for such medical procedures as may be deemed necessary by an examining physician. I also understand that Iona College is not responsible for injury or the loss of any personal items. Applicant’s Name: _____________________________________ Date: ____________________ Parent/Guardian Signature: ________________________________ Date: ___________________ Health Insurance: ________________________________________ Claim # - _______________
