NDS Goalkeeper / Striker Academy at North Dayton Sports
NDS Goalkeeper Academy at Dayton Sports Complex
Academy Camp held at: Dayton Sports Complex 4801 Salem Ave Dayton, Ohio 45416 NDS Academy Director: David Wall NDS Academy Goalkeeping Coach: Catherine Gordon (USSF C-License Coach with Net Edge Training, LLC) NDS Academy Goalkeeping Coach: Corey Whisenhunt (NPSL Goalkeeper with the new Dayton Dynamo)
NorthDaytonSports.com
NDS Striker Academy at Dayton Sports Complex
Academy Camp held at: Dayton Sports Complex 4801 Salem Ave Dayton, Ohio 45416 NDS Academy Director and Striker Coach: David Wall (USSF A-License Coach) NDS Academy Striker Coach: Innocent Hadebe (MWSC Director of Player Development)
NorthDaytonSports.com
PLEASE NOTE: The Goalkeeper / Striker Academy Clinics are very popular and we have limited availability. Please book in plenty of time to avoid disappointment. The Academy caters for players in 2 age brackets:
11 years old to 14 years old
15 years old to 18 years old Each group has a maximum of 16 players in each session. The Goalkeeper / Striker Academy Clinic is perfect for those players that are looking to either become a Goalkeeper or Striker for their clubs or are already a Goalkeeper / Striker and are looking to enhance and improve their knowledge of the positions or for players that are looking for extra skills training.
North Dayton Sports Player Registration First Name_____________________________Last Name_______________________________ Address_______________________________City______________ Zip ________Age ______ Gender:
Male
Female
Home Phone______________________________
Father Name __________________________Cell Phone________________________________ Mothers Name ________________________ Cell Phone________________________________ Parents E-Mail Address_______________________________________________________________________ Goalkeeper Academy: (Ages 10 – 14)
Winter Session 1____ $ 125.00
Winter Session 2____$ 125.00
(Ages 15 – 18)
Winter Session 1____ $ 125.00
Winter Session 2____$ 125.00
Striker Academy: (Ages 10 – 14)
Winter Session 1____ $ 125.00
Winter Session 2____$ 125.00
(Ages 15 – 18)
Winter Session 1____ $ 125.00
Winter Session 2____$ 125.00
Checks made payable to North Dayton Sports (Office use only) Check # _________ Initials _______Received __________(Confirmation will be emailed)
Parental / Guardian Agreement: I, the parent/guardian of the registrant, a minor, agree that I and the registrant will abide by the rules of Dayton Sports Complex /North Dayton Sports LLC, its affiliated organizations and sponsors. Recognizing the possibility of physical injury associated with soccer and in consideration for Dayton Sports Complex /North Dayton Sports LLC accepting the registrant for its soccer programs and activities (the “programs”), I hereby release, discharge and/or agree to otherwise indemnify Dayton Sports Complex /North Dayton Sports LLC, its affiliated organization and sponsors, association, its subcontractors, coaches, managers, and volunteers, including their employees and associated personnel including the owners of fields and facilities utilized for the programs, against any claim by, or on behalf of the registrant as a result of the registrant’s participation in the programs and/or being transported to or from the same, in which transportation is needed.
Consent for Medical Treatment As the parent/legal guardian of a participant in the Dayton Sports Complex /North Dayton Sports LLC, I hereby give my consent for emergency medical care prescribed by a duly licensed Doctor of Medicine or Doctor of Dentistry. This care may be given under whatever conditions are necessary to preserve the life, limb, or well-being of my dependent.
Parent/Legal Guardian Name (please print) _____________________________________ X Signature _______________________________________ Date ____________________ Mail Registration Form/s with Payment To: North Dayton Sports, P.O. Box 44, Troy, OH 45373
Academy Camp held at: Dayton Sports Complex 4801 Salem Ave Dayton, Ohio 45416 NDS Academy Director: David Wall NDS Academy Goalkeeping Coach: Catherine Gordon (USSF C-License Coach with Net Edge Training, LLC) NDS Academy Goalkeeping Coach: Corey Whisenhunt (NPSL Goalkeeper with the new Dayton Dynamo)
NorthDaytonSports.com
NDS Striker Academy at Dayton Sports Complex
Academy Camp held at: Dayton Sports Complex 4801 Salem Ave Dayton, Ohio 45416 NDS Academy Director and Striker Coach: David Wall (USSF A-License Coach) NDS Academy Striker Coach: Innocent Hadebe (MWSC Director of Player Development)
NorthDaytonSports.com
PLEASE NOTE: The Goalkeeper / Striker Academy Clinics are very popular and we have limited availability. Please book in plenty of time to avoid disappointment. The Academy caters for players in 2 age brackets:
11 years old to 14 years old
15 years old to 18 years old Each group has a maximum of 16 players in each session. The Goalkeeper / Striker Academy Clinic is perfect for those players that are looking to either become a Goalkeeper or Striker for their clubs or are already a Goalkeeper / Striker and are looking to enhance and improve their knowledge of the positions or for players that are looking for extra skills training.
North Dayton Sports Player Registration First Name_____________________________Last Name_______________________________ Address_______________________________City______________ Zip ________Age ______ Gender:
Male
Female
Home Phone______________________________
Father Name __________________________Cell Phone________________________________ Mothers Name ________________________ Cell Phone________________________________ Parents E-Mail Address_______________________________________________________________________ Goalkeeper Academy: (Ages 10 – 14)
Winter Session 1____ $ 125.00
Winter Session 2____$ 125.00
(Ages 15 – 18)
Winter Session 1____ $ 125.00
Winter Session 2____$ 125.00
Striker Academy: (Ages 10 – 14)
Winter Session 1____ $ 125.00
Winter Session 2____$ 125.00
(Ages 15 – 18)
Winter Session 1____ $ 125.00
Winter Session 2____$ 125.00
Checks made payable to North Dayton Sports (Office use only) Check # _________ Initials _______Received __________(Confirmation will be emailed)
Parental / Guardian Agreement: I, the parent/guardian of the registrant, a minor, agree that I and the registrant will abide by the rules of Dayton Sports Complex /North Dayton Sports LLC, its affiliated organizations and sponsors. Recognizing the possibility of physical injury associated with soccer and in consideration for Dayton Sports Complex /North Dayton Sports LLC accepting the registrant for its soccer programs and activities (the “programs”), I hereby release, discharge and/or agree to otherwise indemnify Dayton Sports Complex /North Dayton Sports LLC, its affiliated organization and sponsors, association, its subcontractors, coaches, managers, and volunteers, including their employees and associated personnel including the owners of fields and facilities utilized for the programs, against any claim by, or on behalf of the registrant as a result of the registrant’s participation in the programs and/or being transported to or from the same, in which transportation is needed.
Consent for Medical Treatment As the parent/legal guardian of a participant in the Dayton Sports Complex /North Dayton Sports LLC, I hereby give my consent for emergency medical care prescribed by a duly licensed Doctor of Medicine or Doctor of Dentistry. This care may be given under whatever conditions are necessary to preserve the life, limb, or well-being of my dependent.
Parent/Legal Guardian Name (please print) _____________________________________ X Signature _______________________________________ Date ____________________ Mail Registration Form/s with Payment To: North Dayton Sports, P.O. Box 44, Troy, OH 45373
