Men's Soccer Summer ID Camp - sidearm.sites.s3.amazonaws.com
INSURANCE INFORMATION MUST BE COMPLETED AND ON FILE BEFORE CHILD CAN PARTICIPATE IN CLNIC INSURANCE CARRIER__________________________ ___ GROUP NUMBER__________________________ ______ AGREEMENT NUMBER____________________________ PCP____________________________________________ PHONE_________________________________________ RESPONSIBILITY STATEMENT The University of Pittsburgh at Johnstown is not responsible for any damage, expense, or inconvenience, nor any loss, injury or damage to or of any person or property from any cause whatsoever incurred during the Summer Camp Program. The University of Pittsburgh at Johnstown is not held responsible for any act, omission or any event during this program. Only in cases of emergency will the camper be taken for medical treatment. Parents are responsible for transporting campers for non-emergency treatment. My child is in good physical condition, and I accept responsibility for him/her during this program. I have read the above statement and agree with the provisions. I understand there is a risk in this ac vity. I give my permission for my child to par cipate. PARENT/GUARDIAN NAME
Daily Schedule Friday, July 24 11:30 Check‐in 12:30 Campus tour 2:00 Camp mee ng 2:30 Training 4:30 Dinner 6:30 4v4 Tourney 9:30 Mee ng Saturday, July 25 7:30 Breakfast 9:00 Training 12:00 Lunch 2:00 Training 4:30 Dinner 6:30 11v11 Games 9:30 Mee ng Sunday, July 26 7:30 Breakfast 9:00 Training 12:00 Lunch 2:30 7v7 Tourney 4:30 Check‐out
2015 Pitt‐Johnstown Men’s Soccer ID Camp
__________________________________________ If your child has any serious or poten ally serious condi ons, please no fy the coaching staff via email. In case of emergency, please no fy: (Other than parent or guardian) (Parent or guardian will be called first) NAME__________________________________ _______________ PHONE_________________________________________________ RELATION TO CAMPER____________________________________ SIGNATURE OF PARENT/GUARDIAN _______________________________________________________ DATE ______________________________
University of Pittsburgh‐ Johnstown Men’s Soccer 450 Schoolhouse Road Sports Center Johnstown, PA 15904 Head Coach Eric Kinsey Phone: 814‐269‐2034 Fax: 814‐269‐2026 E‐mail: [email protected]
Friday, July 24— Sunday, July 26
About the Camp Head Coach Eric Kinsey will lead the camp sessions with assistance from other college and high-level club coaches. Current Mountain Cat soccer players will assist the camp staff. Specific field player and goalkeeper training will also be provided.
Pitt‐Johnstown ID Camp Registration Form Name ________________________________________ Email address _________________________________ Address ______________________________________ _____________________________________________ City ________________________________
2015 Pitt‐Johnstown Men’s Soccer ID Camp The University of Pittsburgh Johnstown’s Men’s Soccer program will host its ID Camp from Friday, July 24—Sunday, July 26. Check-in will begin at 11:30 a.m. Friday and the camp will conclude at 4:30 p.m. on Sunday. The camp will include seven field sessions at the Pitt-Johnstown athletic fields complex. The camp is open to boys entering grades 9-12 in Fall 2015 who desire to play soccer at the collegiate level and will be limited to 90 participants. Cost of the camp is $225, which includes six meals and two Pitt-Johnstown soccer t-shirts. The camp will expose high school-aged students to the training environment of a collegiate soccer program, as well as give them an insight into the coaching staff’s philosophy. Campers will also have the opportunity to interact with current men’s soccer team members and learn about their experiences at Pitt-Johnstown. For more information, contact Head Coach Eric Kinsey at [email protected] or 814-269-2034.
By the time the camp starts, you should already be reaching a good fitness level in preparation for your high school season. However, it is very important that you are in good shape for this camp. It will be physically demanding and is designed to simulate college level training sessions. Insurance information and a signed waiver (parent signature required if under 18), on the back of the registration form, are required as part of registration. Upon receipt of completed registration form and payment, campers will receive a confirmation e-mail including specific information related to the weekend. Checks should be made payable to Pitt-Johnstown Men’s Soccer in the amount of $225. There is an early bird discount of $25 if registered by May 31.
State _______
ZIP ____________
Parent/Guardian _____________________ Phone (H) __________________________ Phone (C) __________________________ Club Team __________________________ High school _________________________ Grade ______________________________ Desired course(s) of study : ______________________________________ SAT (V) _______ (M) _______ (W) ______ GPA ___________
Please circle T-shirt size: S
M D
L
XL
Primary Position:
GK
M
Height ________
Weight ___________
Make checks payable and mail form to: Pitt-Johnstown Men’s Soccer University of Pittsburgh Johnstown 450 Schoolhouse Road Johnstown, PA 15904
F
Daily Schedule Friday, July 24 11:30 Check‐in 12:30 Campus tour 2:00 Camp mee ng 2:30 Training 4:30 Dinner 6:30 4v4 Tourney 9:30 Mee ng Saturday, July 25 7:30 Breakfast 9:00 Training 12:00 Lunch 2:00 Training 4:30 Dinner 6:30 11v11 Games 9:30 Mee ng Sunday, July 26 7:30 Breakfast 9:00 Training 12:00 Lunch 2:30 7v7 Tourney 4:30 Check‐out
2015 Pitt‐Johnstown Men’s Soccer ID Camp
__________________________________________ If your child has any serious or poten ally serious condi ons, please no fy the coaching staff via email. In case of emergency, please no fy: (Other than parent or guardian) (Parent or guardian will be called first) NAME__________________________________ _______________ PHONE_________________________________________________ RELATION TO CAMPER____________________________________ SIGNATURE OF PARENT/GUARDIAN _______________________________________________________ DATE ______________________________
University of Pittsburgh‐ Johnstown Men’s Soccer 450 Schoolhouse Road Sports Center Johnstown, PA 15904 Head Coach Eric Kinsey Phone: 814‐269‐2034 Fax: 814‐269‐2026 E‐mail: [email protected]
Friday, July 24— Sunday, July 26
About the Camp Head Coach Eric Kinsey will lead the camp sessions with assistance from other college and high-level club coaches. Current Mountain Cat soccer players will assist the camp staff. Specific field player and goalkeeper training will also be provided.
Pitt‐Johnstown ID Camp Registration Form Name ________________________________________ Email address _________________________________ Address ______________________________________ _____________________________________________ City ________________________________
2015 Pitt‐Johnstown Men’s Soccer ID Camp The University of Pittsburgh Johnstown’s Men’s Soccer program will host its ID Camp from Friday, July 24—Sunday, July 26. Check-in will begin at 11:30 a.m. Friday and the camp will conclude at 4:30 p.m. on Sunday. The camp will include seven field sessions at the Pitt-Johnstown athletic fields complex. The camp is open to boys entering grades 9-12 in Fall 2015 who desire to play soccer at the collegiate level and will be limited to 90 participants. Cost of the camp is $225, which includes six meals and two Pitt-Johnstown soccer t-shirts. The camp will expose high school-aged students to the training environment of a collegiate soccer program, as well as give them an insight into the coaching staff’s philosophy. Campers will also have the opportunity to interact with current men’s soccer team members and learn about their experiences at Pitt-Johnstown. For more information, contact Head Coach Eric Kinsey at [email protected] or 814-269-2034.
By the time the camp starts, you should already be reaching a good fitness level in preparation for your high school season. However, it is very important that you are in good shape for this camp. It will be physically demanding and is designed to simulate college level training sessions. Insurance information and a signed waiver (parent signature required if under 18), on the back of the registration form, are required as part of registration. Upon receipt of completed registration form and payment, campers will receive a confirmation e-mail including specific information related to the weekend. Checks should be made payable to Pitt-Johnstown Men’s Soccer in the amount of $225. There is an early bird discount of $25 if registered by May 31.
State _______
ZIP ____________
Parent/Guardian _____________________ Phone (H) __________________________ Phone (C) __________________________ Club Team __________________________ High school _________________________ Grade ______________________________ Desired course(s) of study : ______________________________________ SAT (V) _______ (M) _______ (W) ______ GPA ___________
Please circle T-shirt size: S
M D
L
XL
Primary Position:
GK
M
Height ________
Weight ___________
Make checks payable and mail form to: Pitt-Johnstown Men’s Soccer University of Pittsburgh Johnstown 450 Schoolhouse Road Johnstown, PA 15904
F
