BOBCAT SOCCER ACADEMY

							B O B C A T S OCCER ACADEMY
                                      Offering THREE great sessions
                                    Featuring fun, safe and cutting edge
                                             soccer instruction
                                    Session I, June 20-June 23, 2011
                                                9AM – Noon
                                        (First day registration is at 8:30AM)
                                    Session II, June 27- June 30, 2011
                                                 9AM – Noon
                                         (First day registration is at 4:30 PM)
                                    Session III, June 27- June 30, 2011
                                     5-8 PM** evening session!
                                   For boys and girls entering grades 2-9
                                                   mini camp:
                                   For boys and girls entering grades K-1
                                       5-6:30PM or 9–10:30AM
                                 The camp will take place at THE FIELDS IN THE BACK OF

                              VETERAN’S MEMORIAL PARK

          Camp Information                              Typical Daily Schedule
   THE REGISTRATION SHEET IS ON THE BACK
                                               8:50       Arrival
   OF THIS SHEET!
                                               9:00       Warm Up and Stretching
   REGISTRATION: $125                          9:15       Individual technical training
                                               9:45       Fun small-sided games and drills
   WALK-UP REGISTRATION FEE      $20           10:30      Snack—break time; mini camp ends

   Same Price SINCE 2006!                      10:45 Small group tactics
   Pre register for TWO sessions for a         11:15 Games, contests and
   discounted fee of only $235. All Three             competitions
   for $340!                                   12:00 Dismissal

   Mini camp (k-1) registration is                       Academy Directors:
   $65                                         Melissa Morgan-Hostetler, Head
   If you wish to buy a new soccer ball,       Girls’ Varsity Soccer Coach at SWHS
   include the $15 fee with your check.        Dave St. Jean, Head Boys’ Varsity
                                               Soccer Coach at SWHS
Please make checks payable to:
                                               *Both directors are First Aid and CPR
   Bobcat Soccer Academy                       Certified as well as certified and licensed to
   $25 returned check fee                      teach and coach by the State of Connecticut.

                                               Staff:


Questions:                                     The staff will consist of current SWHS assistant
                                               coaches as well as current and former SWHS
                                               players. Included, as available, will be guest
Phone: (860) 698-9563                          speakers/ clinicians from local clubs and colleges.

Email: bsacamps@cox.net
    Please fill this out and mail it with your signed check to

                             Bobcat Soccer Academy
                                 35 Piper Lane
                             Somers, CT 06071-2242
    Registration Form                                               Health Information
Session (please circle)               1     2     3     ALL           (REQUIRED)
    I am interested in goalkeeper training
                                                                Primary Care Physician: ______________
    I wish to buy a soccer ball ($15)                          Address: __________________________

Name: __________________________                                Telephone #: ______________________

Current Age: _____ Grade in fall _______                        Date of last physical exam: ___________
                                                                Insurance Provider: _________________
T-Shirt size: YOUTH: S M L
                         ADULT: S M L              XL           Hospital of preference: _______________
                                                                Please list and explain any allergies,
                                                                recent injuries and/or medical conditions
Address:___________________________
                                                                that the staff must be aware of.
____________________________________
                                                                _________________________________
Home Phone: ___________________                                 Campers will be divided into divisions by
                                                                age and/or ability to provide the best
Emergency Contact and phone #:                                  possible experience in enjoyment and in
________________________________________                        learning for each camper.
________________________________________

Email Address:
                                                                Campers should bring sneakers and cleats,
_____________________________
                                                                shin guards, a hat, sun block, a drink and
I hereby authorize the staff of the Bobcat Soccer Academy       a snack to the Academy every day. Cold
to act for me according to their best judgment in any           water and shade will be provided for all
emergency requiring medical attention, and I hereby
waive and release the Academy and its staff from any and        players at any time they request it. There
all liability for any injuries incurred while at the Academy.   will also be a staffed concession stand
I understand that participation in soccer and all other
Academy activities carries with it some risk of injury. All     selling cold sports drinks, juice, bottled
medical expenses incurred will be responsibility of the         water and healthy snacks.
camper or the camper's family. I understand that any
medication to be administered to a child during the
Academy must be administered by a parent, other adult,          Parents may set up an “account”
or sibling duly authorized by the parent in writing (contact
the Academy Directors for details). The Academy is not          at the concession stand for their
responsible for personal items that are lost, stolen or         camper at any time.
damaged. I understand the Academy retains the right to
use any photograph, videotapes, motion picture recording

                                                                Questions:
or any other record of the event for publicity, advertising
or any legitimate purpose. I understand and accept the
Academy’s returned check policy fee of $25.
                                                                Phone: (860) 698-9563
Signature of Parent/Guardian:
                                                                Email: bsacamps@cox.net
__________________________