mount mercy university competes in the name midwest …€¦ · coed offensive improvement camp...

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Name

Address

City/Zip

Phone

E-mail

School

Age Ht.

Grade next fall

T-shirt size (please circle one):

Youth: M L Adult: S M L XL

Please indicate the session(s) you plan to attend:

Make checks payable to:Mount Mercy Soccer

Hennessey Recreation Center 1330 Elmhurst Drive NE Cedar Rapids, IA 52402

Total $

Coed Soccer CampGrades 2-12 Monday-Friday, June 16-20

$160 (lunch included)

Session #1 8:30 a.m.-3:30 p.m.

Mount Mercy University competes in the Midwest Collegiate Conference (MCC) and the

National Association of Intercollegiate Athletics (NAIA). The NAIA, which offers 23 championships in 13 sports,

has 50,000 student-athletes participating at nearly 300 member colleges and universities throughout

the United States and Canada.

The NAIA Champions of Character program is an educational outreach initiative which emphasizes the

tenets of character and integrity, not only for NAIA college students, but for younger students, coaches and parents

in our communities. We all have a role in developing students of character, and the NAIA Champions of Character program offers training, guidelines and

behavior models to create positive environments that promote personal growth and fun sport activity.

Coed Offensive Improvement CampGrades 2-10 Monday-Friday, June 9-13

$160 (lunch included)

Session #18:30 a.m.-3:30 p.m.

Please complete the registration form below, or register online at http://mustangcamps.com.

COED OFFENSIVE IMPROVEMENT CAMPGrades 2-10 Monday-Friday, June 9-13

8:30 a.m.-3:30 p.m.$160 (lunch included)

Emphasis is placed on development, improvement and refinement of basic offensive skills. Attention will be given to the instruction of good ball control habits and movement techniques in challenging drills and simulated game situations. We also teach shooting with accuracy and power, dribbling moves, coordination/agility, receiving and preparation, passing, scoring, footwork, juggling and ball control.

COED SOCCER CAMPGrades 2-12 Monday-Friday, June 16-20

8:30 a.m.-3:30 p.m.$160 (lunch included)

The Mount Mercy soccer program invites you to learn and enjoy the game of soccer, in a competitive environment, from former professional player Amir Hadzic. FUNdamentals, as well as sophisticated techniques of soccer, will be taught on a personalized level in addition to group instruction provided by Amir and Mount Mercy players.

All campers will meet at Hennessey Recreation Center on the

Mount Mercy campus. Camp activities will utilize the Franklin Middle School field.

All camp participants will receive a free t-shirt and soccer ball. Plus, each camper will have a chance to win a European pro league replica jersey! Questions? Contact Amir Hadzic at

319-363-1323 ext. 1543 or ahadzic@mtmercy.edu.

Amir HadzicHead Men’s Soccer Coach

Hadzic has helmed the Mount Mercy men’s soccer program for 19 seasons. In 2011, Mount Mercy won its first-ever Midwest Collegiate Conference regular season and tournament titles, and Hadzic was the MCC Coach of the Year for the second season in a row and third time overall. Hadzic is also head boys’ soccer coach at Xavier High School. Fifteen of Hadzic’s Mount Mercy players have become head coaches throughout the country, including six in the Cedar Rapids and Iowa City area.

Alen KudumovicKudumovic, a four-time all-conference performer at Mount Mercy, was the MCC Player of the Year and an NAIA all-American in 1999. He was inducted into the Mount Mercy Athletics Hall of Fame in March 2011. Kudumovic is currently the director of coaching for the Cedar River Soccer Association and holds the United States Soccer Federation National "B" license.

Drago CeranicCamp Director

Ceranic was a four-time all-conference performer at Mount Mercy and the first Mustang to play in the prestigious Premier Development League with the Vermont Voltage from 2007-11. In addition, he helped organize and direct the club’s summer soccer camps with more than 600 participants. Currently, Ceranic is coaching at the CRSA soccer club in Cedar Rapids.

Mount Mercy University Camps & ClinicsMedical Information, Parental Consent and Waiver Form

All areas of this form must be completed and signed prior to camp participation.

Camper’s Name ________________________________________Birth Date ____________________________________________

Allergies and MedicationsAllergic reactions (drugs, food, asthma) _______ No ________ Yes If yes, list: _____________________________________________Taking any medication at this time? ______ No _____________ YesIf yes, list: _____________________________________________

In Case of EmergencyFather Tel (H) _____________ (W) ___________(C) ___________Mother Tel (H) ____________ (W) ___________(C) ___________Other Emergency Contact:Name ________________________________________________Tel (H) __________________ (W) ___________(C) ___________Guardian’s Name _______________________________________Relationship ___________________________________________

Your Medical InsuranceCompany _____________________________________________Policy # ______________________________________________Name of Policy Holder ___________________________________

I certify that I am the parent or legal guardian of the Camper. I hereby give permission for the staff of the camp, to seek, during the period of the camp, appropriate medical attention for the Camper; and for medical attention to be given: and for the Camper to receive medical attention in the event of accident, injury, or illness. I understand and agree that neither Mount Mercy University nor the camp carry insurance for injuries sustained by participants of its programs. I have reviewed the medical insurance coverage for my child/ward and have determined that it is adequate. I agree to assume the full risk of any injuries, including death, damages, or loss regardless of severity, which I or my child/ward may sustain as a result of participating in any and all activities connected with or associated with such camp. I waive, release, agree to not sue for, and relinquish all claims against Mount Mercy University, its officers, directors, agents, insurers, employees and camp staff that I or my child/ward may have as a result of participating in the camp. I further agree to indemnify, hold harmless and defend Mount Mercy University, its officers, directors, agents, insurers, employees and camp staff from any and all claims from injuries, including death, dam-ages, and losses sustained by me or my child/ward or arising out of, connected with, or in any way associated with the activities of the camp. I agree that any photography taken of me or my child/ward while participating in the Mount Mercy University summer camps may be used for promotional purposes for Mount Mercy University or the camp.

Signed _____________________________ Date _____________

Printed Name__________________________________________

Relationship to Camper __________________________________

Chad HollmerDuring Hollmer's playing career at Mount Mercy, he was an NAIA Champion of Character and team captain. He is now a full-time soccer coach in Cedar Rapids, working with multiple youth teams in the Cedar River Soccer Association (CRSA). In the spring, he will enter his second season at the Head Girls' Soccer Coach at Cedar Rapids Washington High School.

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