2012 RAD Field Hockey Camp

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					                                                                                                               2012 RAD
                                                                                                           Field Hockey Camp
                                                                                                           Hosted by Millersville University

      Camper Insurance Information
      It is the responsibility of the camper’s
   Parents and/or guardians to ensure that the
 camper is healthy and has no physical problems
 that would prevent her from participation in the
camp and all camp activities being held. Primary                                                            RAD FIELD HOCKEY CAMP
insurance coverage rests with the camper and her                                                             Hosted by Millersville University
              parents and or guardians.

                                                                                                                   July 12 –15
                                                                                                               For Teams and Individuals
Campers Name____________________________________                                                              Held at Chryst Turf Stadium on the
                                                                                                                Millersville University Campus
Insurance Company______________________________
                                                                                                                  Resident Camper
Medical Concerns/Injures________________________
                                                                                                              Team/Group Campers
                                                                164 West Cottage Avenue / Jefferson Hall

_____________________________________________________                                                          10 campers or more to qualify
                                                                c/o RAD & MU Field Hockey Camp

                                                                                                              Extended Day Camper
Emergency Contact(s) ___________________________
Primary Ph.# (_______) ____________________________                                                           ONLINE REGISTRATION & PAYMENT
                                                                Millersville, PA. 17551

                                                                                                                     NOW AVAILABLE
  This is to certify that my daughter has had a physical
examination by a licensed physician in the last six months
and is free from any illness, injuries, or defects that would
                                                                Shelly Behrens

   inhibit any or all participation in the activities of the
                       RAD, llc camps.

Parent or Guardian Signature

Date _____________________________________     2012

Please be sure this side is completed & returned with the
        camper’s application on the reverse side.
                   Camp Program                                               Pre-Registration                              FIELD HOCKEY CAMP APPLICATION
The MU & RAD Camp meets the needs of today’s Field         To confirm your place, submit the application and              Resident Camper
Hockey player. A fun and competitive environment           $100.00 non-refundable deposit to the address                  July 12-15    $400.00
where the player’s learning and growth comes first.        below. A full payment will also hold a camper’s place.
More FH is taught & played with us than at any other       Space is limited for a quality teaching environment!           Team/Group Camper
camp! Comprehensive instruction, whether an                Those not admitted due to full camp will be put on a
                                                                                                                          July 12-15    $375.00
individual or a team! We teach the skills, tactics &       wait list. Only Teams or Groups of 10 or more qualify
concepts needed to improve and elevate your play for       for the group rate. We request ALL TEAMS send their            Extended Day Camper
the game. Specialized GK instruction for goalkeepers!      information TOGETHER so they can all qualify for group
The Camp is open to all individuals.                       rate! Contact us with any questions! All checks & money        July 12-15     $325.00
                                                           orders should be made out to “Field Hockey camp, ssi”.                  Check 1 box for Camper Status
             ~ WHY RAD CAMPS ~                             Once the camp application & deposit fee are received a
                  Small teaching groups                    confirmation will be sent. Final payment is due on or                         Please Print Clearly
             New skills & trends in the game               prior to July 2nd 2012.
           College recruitment & NCAA session                                                                             Name__________________________________
         International Coaches when available
     Daily Goal Shooting / Lots of Scoring situations
                                                                              Camp Information
                                                                             To register online go to:                    Address_________________________________
         Team Building skills & Guest Speakers
                                                   CAMPS, FH, you will
            Strength & sports psych training                                                                              _______________________________________
                                                            then be directed to the online site, please note there is a
         Evening play under lights with coaches
                                                            convenience fee and it is for full payment only
       Air Conditioned dorm rooms at Millersville                                                                         City____________________________________
          Camp Store with Hockey gear & food                              To pay by check or money order:
     USA FH Team Members at camp when available             RAD Field Hockey Camp,                                        State__________________          Zip____________
                                                            164 West Cottage Avenue / Jefferson Hall
               RAD Camp Senior Staff
                                                            Millersville, PA 17551                                        Phone (______) __________________________
Shelly Behrens –Owner/Director of RAD & Head Coach          Contact Coach Shelly Behrens with questions at                Email__________________________________
with Millersville Field Hockey; Assistant Coach with USA or 717-872-3834
National Sr. Team & USA U-21 Team Pan American Team                                                                       HS Attending____________________________
& numerous Tours & USA FH Development Selector.            Facilities and Details: The RAD FH Camp is held at
                                                           Chryst Turf field on the Millersville Campus. Overnight        Age_________ Position____________________
Katie Gerfen – Events Coordinator for RAD, Solanco FH      Campers stay at Air Conditioned dorms. The dining hall
Head Coach, 2x Captain & All-American from the                                                                            Grade Entering in Fall 2012_________________
                                                           food is all home-made at MU. All Camper information
University of Virginia, competed as a member of the        such as ; check-in/out process, directions to camp will
U-19 & U16 USA Teams. Former Assistant Coach at                                                                           Years Played    V______JV_____Other_______
                                                           be available at Millersville Field Hockey Camp website
Ohio University and Indiana University                     along with a suggested checklist of what to bring to           Club FH Team___________________________
                                                           make their time at FH Camp a huge success!
Tess Ellis – Co-Founder of RAD, Associate Head Coach                                                                      RESIDENT CAMPERS-1 ROOMATE CHOICE,
with W&M Field Hockey, former USA FH & U-21 National                                                                              first & last name of choice please
Coach & National Sr. Team Assistant Coach, coached                           Daily Schedule
numerous Tours & USA FH Development Selector.                Morning –skills & competitions, Off. & Def. concepts         ____________________________________________
                                                             Afternoon – shooting, scoring, tactics, situations,
The RAD/MU Field Hockey Camp staff will be both              Evening – nightly games, competitions, individual                             Office Use Only
International and Collegiate Head and Collegiate             time to work with coaches, free time with campers
Assistant coaches and top High school Coaches.                   **Nightly Games with coaches-offered for all**           Date & Deposit Rec’d.________ Amt Paid________

                                                              Extended Day Campers – 9am-8/8:30pm – lunch &               Payment Due $_____________        PIF____________
                                                                dinner the daily schedule & contact information
                                                              provided to campers & parents at the camp check-in.         RC____ G_____ EXDC_____ CK #___________
                                                              A day camper area is provided during the day at the
                                                                dorm for campers to relax in between sessions!

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