PILO Soccer Academy

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					                                                                                                                 PILO SOCCER ACADEMY
  PILO Soccer Academy
                                                                                                                             What to Bring:
     Waiver/Release                                                                      Come Learn Soccer The        A great ready to learn attitude
                                                                                            Brazilian Way!            Water & Snack or money to
                                                                                                                       purchase from the concession
Player’s Name____________________________________________
                                                                                                                      A ball, appropriate size for age
DOB______________ Age ________ Academy ___________________

Address_________________________________________________
                                                                                          PILO Soccer                 Shin-guards
                                                                                                                       Sunscreen
City__________________________ Zip________________                                          Academy                

Home Phone_____________________________________________
                                                                                                                             Daily Programs:
Parent Names____________________________________________
                                                                                                                      Individual Ball Skills Training
Emergency Contact Information
                                                                                                                      Attacking and Defensive Tactics
Name___________________________________________________
                                                                                                                      Passing and Receiving
Phone___________________________________________________
                                                                                                                      1 v 1 Sessions
                                                                                                                      Small Side Games
Check the appropriate blank and complete information in Item 1, if applicable.                                        Coached Scrimmages
_____ 1. This is to certify that my child is covered by the following accident                                        World Cup Tournament
insurance,

_______________________________________________________
                                                                                                                 The skills learned in daily program will
             (name of company and type of policy)
                                                                                                                 be applied and reinforced during small
And has my permission to participate in all camp activities. It is agreed that the
                                                                                                                 side games, coached scrimmages, and
camp will be relieved of all responsibility in the event of an injury.
                                                                                                                             tournament play.
_____ 2. This is to certify that my child will be covered by a student accident
policy.

_____ 3. This is to certify that we have NO INSURANCE policy which will cover
                                                                                         “JOGA BONITO”
my child. However, he has my permission to participate in all camp activities. It
is further agreed that the camp will be relieved of all responsibility in the event of
an injury.

Parent Signature___________________________________________                               “Play Beautiful”

Date____________________________________________________
             PILO                            PILO Soccer Academy Staff
            Soccer                                      Camp Director:                        PILO Soccer Academy
           Academy
     July 24th – July 28th
                                          Carlos ‘PILO’ Godoy
     9:00 AM —12:00PM                                                                        Registration Form
   Boys and Girls: U6 to U8             Coach PILO has 30+ years of playing and
                                        coaching at all levels. He is a native of
     July 24th – July 28th              Brazil, the country with the richest                 Instructions:
      6:00 PM — Sunset
                                        history and traditions of success in the             Fill out this form (front and back), tear it off,
  Boys and Girls: U10 to U16
                                        world. He wants to share his love for the            mail it with check payable to
The PILO Soccer Academy will provide    game and the joy it brings with it to the
a positive and fun environment, while   youth players of today.                              FGSC
   still focusing on improving soccer
 techniques. Our goal is to produce a                                                        PO Box 2048
                                        PILO holds Class A licenses with:
more complete player that plays with                                                         Ft. Gibson, OK 74434
             joy and passion!!!          CBF– Confederation of Brazilian Futbol
                                         CFF- Colombian Futbol Federation
                                         USSF - US Soccer Federation                        Free T-Shirt for all attendees if registered by
   Camps are held at the:
                                                                                             Thursday, July 20th!!! Register Early!!!
  Fort Gibson Soccer Complex             FIFA – Academy License
   Behind High Academy Football Field


For more information contact:           PILO has held prestigious coaching                   T-Shirt Size: circle

     Derek Ford @ 478-3872              positions with the international teams of            YM — YL — AS – AM — AL — AXL

    derek.ford@sbcglobal.net            Guyana, Nigeria, South Korea, and Fiji.
               OR                                                                            Amt. Due_________         Amt. Pd. ________
Carlos ‘PILO’ Godoy @ 289-9207          PILO has also held coaching positions with           Balance Due at Camp ________
     pilosoccer@hotmail.com             Professional teams in Saudi Arabia,
                                        Germany, Colombia, and his native Brazil.
              Cost:
        $65 for U6 & U8                                                                      A minimum $35 deposit is due at
       $75 for U10 to U16                                                                    time of registration! This deposit
                                                                                             is non-refundable!
  Price includes free T-Shirt for       Camp Staff:
attendees registered by July 20th       Coach PILO will be assisted by members of the club
                                        staff: Derek Ford, Billy Whitehead, Tommy            Registration is accepted up to
                                        Neffendorff, and Zach Hobbs.                         start of camp, walk-ups welcome.

				
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posted:10/17/2011
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