Soccer camp
Minnesota State University Moorhead Department Of Intercollegiate Athletics Youth Programs Consent For Participation And Medical Information
Schedule: Friday
Emergency contact phone #____________________________________
12:00-2:30 pm: Registration 2:30 pm: Player meeting 3:15 pm: Team training session 6:00 pm: Dinner BBQ (For all campers) 8:00 pm: Fun activity 10:30 pm: Lights out
Medical Insurance Co._________________________________________
Saturday
Regular Session and Position Camp
Child’s Name _________________________________ Age __________ In case of emergency, contact ___________________________________
Policy No. __________________________ Group No. _______________ Physician Name _____________________________________________ Phone ______________________________________________________ Medical conditions the youth program staff and medical emergency services personnel need to be made aware of: ___________________________________________________________ ___________________________________________________________ I wish to register my minor child, ____________________ and consent to my child’s participation in the Summer Sports Camps and/or Leagues sponsored by the Department of Intercollegiate Athletics of Minnesota State University Moorhead during the summer. I recognize that participation in recreational and instructional activities, even when well supervised and managed, pose a risk of physical injury to my child, and I agree to assume such a risk on behalf of my child. I understand that children registered for MSUM Athletics’ summer sport camps and/or leagues will receive instruction in the basic principles of sport(s) of their choice(s) and will spend a significant amount of time practicing and performing sporting techniques and/or researching and performing a variety of enrichment techniques under the supervision of experienced instructors, and I consent to my child’s participation in this program. I certify that my child has no medical condition or impairment, including the use of medication, that might inhibit his participation.
7:30 am: Breakfast 8:30-11:30 am: Technical training session (3v3)/ (4v4) 12:00 pm: Lunch 1:00-2:30 pm: Film session 3:00 pm: Training session (7v7) 6:00 pm: Dinner 7:30-9:00 pm: (11v11) 9:30-11:00 pm: Movie with the campers 11:30pm: Lights out
Sunday 7:30-8:30 am: Breakfast 9:00-11:00 am: Team training (11v11) 11:00-11:30 am: Camp Awards 12:00-1:00 pm: Check Out
Soccer Camp Scholarship A camp scholarship is available through inSports Foundation to help reduce costs to attend. Please visit insportsfoundation.org for more information.
RELEASE OF LIABILITY
Cancellation and Refund policy
I, the undersigned, hereby hold Minnesota State University Moorhead and the entire MSUM Dragon Athletics' Staff harmless from liability for any and all medical and/or accident expenses which my minor child may incur during his involvement in the Summer Sports camps and/ or leagues at the Department of Intercollegiate Athletics, MSUM. I hereby certify that my child is provided coverage via personal health and accident insurance in effect which is sufficient to cover any and all of the expenses, noted above, which might incur.
There’s a $100 non-refundable registration fee. We must have a written note of cancellation emailed to the ID camp director [email protected] Cancellation 21 days prior to camp: All fees refunded except 130 Cancellation 14 days prior to camp: All fees refunded except $210 Cancellation day of camp: No refund unless there’s a medical issue. A note from the physician must be emailed to Camp ID Director.
Parent/Guardian Signature: ____________________________________ Print Parent/Guardian Name:___________________________________
Minnesota State University Moorhead is an equal opportunity educator and employer and is a member of the Minnesota State Colleges and Universities System. This information will be made available in alternate format upon request by contacting Disability Services at 218.477.4318 (voice) or 1.800.627.3529 (MRS/TTY).
June 19-21, 2015 Dragon Women's ID
Soccer camp
Experience college soccer at the NCAA Division II level. We strive to provide campers with a complete college soccer experience. The campers will be exposed to college level training and film sessions. All sessions will be conducted by the MSUM women’s soccer coaching staff at the MSUM soccer complex fields and campus facilities. In addition to the competitive college soccer experience, resident campers will gain insight into the social aspect of college life. Campers will dine at a campus facility, participate in team building activities and spend two nights in the residence hall with fellow campers.
Coaching Staff The camp’s coaching staff is composed of highly qualified coaches with numerous years of playing and coaching at the collegiate level. The coaching staff is experienced in both teaching and demonstrating the necessary skills for a camper to achieve her full potential. The coaches are knowledgeable in all positions on the field, including GK training. All the sessions will be created and directed by the MSUM Women’s Soccer Coaching Staff.
Rollie Bulock MSUM Women’s Soccer Head Coach Uchenna Ogbonnaya MSUM Women’s Soccer Asst. Coach Jon Melendez MSUM Women’s Soccer Asst. Coach Anna Hulteng MSUM Women’s Soccer Speed and Agility Coach
Conformation Information
Each player will receive a conformation email upon receiving full payment, registration form, and medical waiver.
Camp Updates Camp updates will be conducted via email to all registered campers. Please provide an email address that you check frequently.
Airport Pick-up/ Drop-off Information Please Contact Camp Director to arrange pick-up/ drop-off from Fargo Hector International airport.
What to bring ▸▸ Sunscreen ▸▸ Soccer equipment ▸▸ Outdoor shoes( cleats) ▸▸ Indoor shoes ( running shoes or Indoor flats) ▸▸ Shin guards ▸▸ Personal backpack for your soccer equipment during training ▸▸ Water bottle ▸▸ Extra clothes for Hot, cold, and rainy days ▸▸ Personal Bathroom Items
Send U.S. Funds Only to: MSUM Women Soccer Attention– Dragon Women’s ID Camp 1104 7th Ave S Moorhead, MN 56563 (Checks payable to MSUM Women Soccer)
Camp Overview
Camp Caching Staff
Resident Camper Tuition: $275.00 (Includes T-shirt, meals, housing and pick-up/drop off if needed) Commuter Camper Tuition: $250.00 (Does Not include meals or housing but does include T-shirt, and pick-up/drop-off if needed)
Open to: girls entering grades 9th through 12th This camp is designed for residence and commuter campers Duration: 3 day camp (Friday, Saturday, and Sunday) Location: MSUM Campus Address: 1711 6th Ave south, Moorhead, MN 56563 Resident Camper Tuition: $275.00 (Includes meals, housing and pick-up/drop off if needed) Commuter Camper Tuition: $250.00 (DOES NOT include meals or housing but does include pick-up/ drop-off if needed)
2015 MSUM Women’s Soccer ID Camp Registration Form
June 19-21, 2015
Camper’s Name_______________________________________________________________________________________________________________________ Address______________________________________________________ City_________________________________ State___________ Zip_________________ Phone (Home)_________________________________ Email_________________________________________________________________________________ Age___________ Height_____________ T-Shirt Size (circle): Youth Size: S M L XL XXL OR Adult Size: S M L XL XXL Entering grade (circle): Freshmen (9th) Sophomore (10th) Junior (11th) Senior(12th) Please note any medical conditions that we should be aware of (attach an additional sheet if necessary)_______________________________________________
Soccer Dragon Women's ID Soccer Camp
Schedule: Friday
Emergency contact phone #____________________________________
12:00-2:30 pm: Registration 2:30 pm: Player meeting 3:15 pm: Team training session 6:00 pm: Dinner BBQ (For all campers) 8:00 pm: Fun activity 10:30 pm: Lights out
Medical Insurance Co._________________________________________
Saturday
Regular Session and Position Camp
Child’s Name _________________________________ Age __________ In case of emergency, contact ___________________________________
Policy No. __________________________ Group No. _______________ Physician Name _____________________________________________ Phone ______________________________________________________ Medical conditions the youth program staff and medical emergency services personnel need to be made aware of: ___________________________________________________________ ___________________________________________________________ I wish to register my minor child, ____________________ and consent to my child’s participation in the Summer Sports Camps and/or Leagues sponsored by the Department of Intercollegiate Athletics of Minnesota State University Moorhead during the summer. I recognize that participation in recreational and instructional activities, even when well supervised and managed, pose a risk of physical injury to my child, and I agree to assume such a risk on behalf of my child. I understand that children registered for MSUM Athletics’ summer sport camps and/or leagues will receive instruction in the basic principles of sport(s) of their choice(s) and will spend a significant amount of time practicing and performing sporting techniques and/or researching and performing a variety of enrichment techniques under the supervision of experienced instructors, and I consent to my child’s participation in this program. I certify that my child has no medical condition or impairment, including the use of medication, that might inhibit his participation.
7:30 am: Breakfast 8:30-11:30 am: Technical training session (3v3)/ (4v4) 12:00 pm: Lunch 1:00-2:30 pm: Film session 3:00 pm: Training session (7v7) 6:00 pm: Dinner 7:30-9:00 pm: (11v11) 9:30-11:00 pm: Movie with the campers 11:30pm: Lights out
Sunday 7:30-8:30 am: Breakfast 9:00-11:00 am: Team training (11v11) 11:00-11:30 am: Camp Awards 12:00-1:00 pm: Check Out
Soccer Camp Scholarship A camp scholarship is available through inSports Foundation to help reduce costs to attend. Please visit insportsfoundation.org for more information.
RELEASE OF LIABILITY
Cancellation and Refund policy
I, the undersigned, hereby hold Minnesota State University Moorhead and the entire MSUM Dragon Athletics' Staff harmless from liability for any and all medical and/or accident expenses which my minor child may incur during his involvement in the Summer Sports camps and/ or leagues at the Department of Intercollegiate Athletics, MSUM. I hereby certify that my child is provided coverage via personal health and accident insurance in effect which is sufficient to cover any and all of the expenses, noted above, which might incur.
There’s a $100 non-refundable registration fee. We must have a written note of cancellation emailed to the ID camp director [email protected] Cancellation 21 days prior to camp: All fees refunded except 130 Cancellation 14 days prior to camp: All fees refunded except $210 Cancellation day of camp: No refund unless there’s a medical issue. A note from the physician must be emailed to Camp ID Director.
Parent/Guardian Signature: ____________________________________ Print Parent/Guardian Name:___________________________________
Minnesota State University Moorhead is an equal opportunity educator and employer and is a member of the Minnesota State Colleges and Universities System. This information will be made available in alternate format upon request by contacting Disability Services at 218.477.4318 (voice) or 1.800.627.3529 (MRS/TTY).
June 19-21, 2015 Dragon Women's ID
Soccer camp
Experience college soccer at the NCAA Division II level. We strive to provide campers with a complete college soccer experience. The campers will be exposed to college level training and film sessions. All sessions will be conducted by the MSUM women’s soccer coaching staff at the MSUM soccer complex fields and campus facilities. In addition to the competitive college soccer experience, resident campers will gain insight into the social aspect of college life. Campers will dine at a campus facility, participate in team building activities and spend two nights in the residence hall with fellow campers.
Coaching Staff The camp’s coaching staff is composed of highly qualified coaches with numerous years of playing and coaching at the collegiate level. The coaching staff is experienced in both teaching and demonstrating the necessary skills for a camper to achieve her full potential. The coaches are knowledgeable in all positions on the field, including GK training. All the sessions will be created and directed by the MSUM Women’s Soccer Coaching Staff.
Rollie Bulock MSUM Women’s Soccer Head Coach Uchenna Ogbonnaya MSUM Women’s Soccer Asst. Coach Jon Melendez MSUM Women’s Soccer Asst. Coach Anna Hulteng MSUM Women’s Soccer Speed and Agility Coach
Conformation Information
Each player will receive a conformation email upon receiving full payment, registration form, and medical waiver.
Camp Updates Camp updates will be conducted via email to all registered campers. Please provide an email address that you check frequently.
Airport Pick-up/ Drop-off Information Please Contact Camp Director to arrange pick-up/ drop-off from Fargo Hector International airport.
What to bring ▸▸ Sunscreen ▸▸ Soccer equipment ▸▸ Outdoor shoes( cleats) ▸▸ Indoor shoes ( running shoes or Indoor flats) ▸▸ Shin guards ▸▸ Personal backpack for your soccer equipment during training ▸▸ Water bottle ▸▸ Extra clothes for Hot, cold, and rainy days ▸▸ Personal Bathroom Items
Send U.S. Funds Only to: MSUM Women Soccer Attention– Dragon Women’s ID Camp 1104 7th Ave S Moorhead, MN 56563 (Checks payable to MSUM Women Soccer)
Camp Overview
Camp Caching Staff
Resident Camper Tuition: $275.00 (Includes T-shirt, meals, housing and pick-up/drop off if needed) Commuter Camper Tuition: $250.00 (Does Not include meals or housing but does include T-shirt, and pick-up/drop-off if needed)
Open to: girls entering grades 9th through 12th This camp is designed for residence and commuter campers Duration: 3 day camp (Friday, Saturday, and Sunday) Location: MSUM Campus Address: 1711 6th Ave south, Moorhead, MN 56563 Resident Camper Tuition: $275.00 (Includes meals, housing and pick-up/drop off if needed) Commuter Camper Tuition: $250.00 (DOES NOT include meals or housing but does include pick-up/ drop-off if needed)
2015 MSUM Women’s Soccer ID Camp Registration Form
June 19-21, 2015
Camper’s Name_______________________________________________________________________________________________________________________ Address______________________________________________________ City_________________________________ State___________ Zip_________________ Phone (Home)_________________________________ Email_________________________________________________________________________________ Age___________ Height_____________ T-Shirt Size (circle): Youth Size: S M L XL XXL OR Adult Size: S M L XL XXL Entering grade (circle): Freshmen (9th) Sophomore (10th) Junior (11th) Senior(12th) Please note any medical conditions that we should be aware of (attach an additional sheet if necessary)_______________________________________________
Soccer Dragon Women's ID Soccer Camp
