Goalkeeper Camp
REGISTRATION: Camper Name: Address:
Centenary University
City:
State:
Zip:
Women’s Soccer
Telephone: Email: DOB:
Age:
Goalkeeper Camp
School/College Grade/Year T-Shirt Size
Y S YM
S M
L
(Please Circle)
Goal Keeper Camp (limited space) Cost TIME:
$75 9-2 pm
Detach application and mail with check to: Kevin Davies Attn: Women’s Soccer (Goalie Camp) 400 Jefferson Street Hackettstown, NJ 07840
www.centenarycyclones.com A non-refundable deposit of $30 must be enclosed with the camp registration form. Full payment is due by June 19th, 2017. Any registration received after June 19th 2017, will require full payment. Please make checks payable to: Centenary Women’s Soccer
Leading the camp will be Jillian Loyden, the former U.S. Women’s National Team Goalkeeper who was the only player to ever be named the BIG EAST Goalkeeper of the Year three times after an impressive career at Villanova. Loyden has also earned a gold medal in the 2012 London Olympics, a silver at the 2011 Women’s World Cup and was named a fifth-round draft pick to St. Louis Athletica in 2009. Centenary University Kevin Davies Head Women’s Soccer Coach Office: (908) 852—1400 ext: 2292 Fax: (908) 813—8295
High School/College Keepers
Schedule of Events
General Camp Information
The Cyclone Girls Goal Keeper Camp is
2017 Girls Goal Keeper Camp
designed for High School & College -age 9:00am - 2.00pm
players
$75.00 The camp will be held at the J.E. Reeves Turf Field at Centenary University, 715 Grand Avenue, Hackettstown, NJ 07840.
It is important that players arrive in a timely manner in order for camp to start and end on time. It is also imperative that players are picked up in a timely fashion once each day of camp is done. Camp Checklist
Camp Schedule 9am-12.15pm Field Sessions
turf shoes /cleats & Gloves
sneakers or indoor shoes
shin guards
water or a sports drink
Campers are responsible for bringing their own lunch each day to camp. For more information contact:
MEDICAL RELEASE FORM I herby give permission for __________________________to participate in the Centenary University Girls Goalkeeper Camp. I certify that my daughter is in good physical condition, has been examined within the last 12 months and no medical reason has been found that he can not participate in this camp. Records show that all immunizations are up to date. I understand that he will be participating in rigorous play and activity. Centenary University Personnel have also been informed of any physical limitations, medications or prior conditions. The camp will safeguard the health of my child but will not be responsible for accidents, injuries or sickness on the way to the camp, during the camp or on the way home. I agree that in the case of an accident involving my child while attending this camp, and with full awareness that soccer is an activity that may involve risk or injury, I release Centenary University and the staff of Centenary University Girls Goalkeeper Camp from any and all liability. I herby request that my child be granted admittance into the Centenary University Girls Goalkeeper Camp and authorize the directors to act on my behalf in the event of an emergency requiring medical attention. I will assume responsibility for payment for any such attention and have provided current insurance information as requested. Player’s Name ________________________Age_____ Parent(s) Name(s) _____________________________ Parent(s) Daytime Phone ________________________ Home Phone _________________________________ Emergency Contact ____________________________ Relationship _________Contact Phone# ___________
Lunch 12.15– 12.45pm
Kevin Davies, Head Women’s Soccer Coach at 908-852-1400 ext. 2292 or e-mail at
Play 1-2pm
[email protected]
Policy #______________________________________
Schedule is Flexible
Insurance Carrier______________________________
Previous Medical Conditions _____________________ By Signing below, I agree to all the terms detailed above Parent/Guardian Signature ______________________
www.centenarycyclones.com
Date_______________
Centenary University
City:
State:
Zip:
Women’s Soccer
Telephone: Email: DOB:
Age:
Goalkeeper Camp
School/College Grade/Year T-Shirt Size
Y S YM
S M
L
(Please Circle)
Goal Keeper Camp (limited space) Cost TIME:
$75 9-2 pm
Detach application and mail with check to: Kevin Davies Attn: Women’s Soccer (Goalie Camp) 400 Jefferson Street Hackettstown, NJ 07840
www.centenarycyclones.com A non-refundable deposit of $30 must be enclosed with the camp registration form. Full payment is due by June 19th, 2017. Any registration received after June 19th 2017, will require full payment. Please make checks payable to: Centenary Women’s Soccer
Leading the camp will be Jillian Loyden, the former U.S. Women’s National Team Goalkeeper who was the only player to ever be named the BIG EAST Goalkeeper of the Year three times after an impressive career at Villanova. Loyden has also earned a gold medal in the 2012 London Olympics, a silver at the 2011 Women’s World Cup and was named a fifth-round draft pick to St. Louis Athletica in 2009. Centenary University Kevin Davies Head Women’s Soccer Coach Office: (908) 852—1400 ext: 2292 Fax: (908) 813—8295
High School/College Keepers
Schedule of Events
General Camp Information
The Cyclone Girls Goal Keeper Camp is
2017 Girls Goal Keeper Camp
designed for High School & College -age 9:00am - 2.00pm
players
$75.00 The camp will be held at the J.E. Reeves Turf Field at Centenary University, 715 Grand Avenue, Hackettstown, NJ 07840.
It is important that players arrive in a timely manner in order for camp to start and end on time. It is also imperative that players are picked up in a timely fashion once each day of camp is done. Camp Checklist
Camp Schedule 9am-12.15pm Field Sessions
turf shoes /cleats & Gloves
sneakers or indoor shoes
shin guards
water or a sports drink
Campers are responsible for bringing their own lunch each day to camp. For more information contact:
MEDICAL RELEASE FORM I herby give permission for __________________________to participate in the Centenary University Girls Goalkeeper Camp. I certify that my daughter is in good physical condition, has been examined within the last 12 months and no medical reason has been found that he can not participate in this camp. Records show that all immunizations are up to date. I understand that he will be participating in rigorous play and activity. Centenary University Personnel have also been informed of any physical limitations, medications or prior conditions. The camp will safeguard the health of my child but will not be responsible for accidents, injuries or sickness on the way to the camp, during the camp or on the way home. I agree that in the case of an accident involving my child while attending this camp, and with full awareness that soccer is an activity that may involve risk or injury, I release Centenary University and the staff of Centenary University Girls Goalkeeper Camp from any and all liability. I herby request that my child be granted admittance into the Centenary University Girls Goalkeeper Camp and authorize the directors to act on my behalf in the event of an emergency requiring medical attention. I will assume responsibility for payment for any such attention and have provided current insurance information as requested. Player’s Name ________________________Age_____ Parent(s) Name(s) _____________________________ Parent(s) Daytime Phone ________________________ Home Phone _________________________________ Emergency Contact ____________________________ Relationship _________Contact Phone# ___________
Lunch 12.15– 12.45pm
Kevin Davies, Head Women’s Soccer Coach at 908-852-1400 ext. 2292 or e-mail at
Play 1-2pm
[email protected]
Policy #______________________________________
Schedule is Flexible
Insurance Carrier______________________________
Previous Medical Conditions _____________________ By Signing below, I agree to all the terms detailed above Parent/Guardian Signature ______________________
www.centenarycyclones.com
Date_______________
