liberty university medical info camp info and …€¦ · please fill out the application and...

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Please fill out the application and parental consent form and return it with your deposit to reserve your space at camp. Session 1 Senior Advanced Skills Camp June 23 - June 27, 2013 Boys Grades 8-12 Session 2 Individual Day Camp For Boys and Girls July 15 - 18, 2013 Presents THE 2013 Jeff Alder Soccer Camps 434-473-9214 Sponsored in part by CAMP INFO Session 1: June 23 - June 27, 2013 Registration and Check in : 5-6 p.m. June 23 Camp ends at 12:00 p.m. on Thursday, June 27 Your Balance is Due June 13 We do not provide any meals until Monday morning. This camp caters to the high school student who seeks to sharpen his skill level and has a strong interest to play at the collegiate level. The senior advanced camp is open to anyone who is presently in grades 8-12. The camp will give the Student-Athlete the opportunity to be coached and evaluated by the Liberty University soccer staff. Each player will learn about how the College recruiting process works, what college coaches are looking for in a player, and how to better present himself as a college prospect to coaches through the use of resumes, videotapes, etc. Camper Benefits Daily devotions Tactical training Small-sided games Liberty Soccer T-shirt College recruiting sessions Cost The cost of the Senior Advanced camp is $400.00 and includes four nights lodging, 10 meals (breakfast on Monday through breakfast on Thursday), and a Liberty Soccer T-shirt. The cost for the day camper is $300.00 and includes lunch and dinner on Monday, Tuesday, and Wednesday, and a Liberty Soccer T- shirt. The coaching staff will be staying with the camp- ers to provide supervision. Transportation Each Senior advanced Camper is responsible for his own transportation to and from the camp. Lynchburg Regional Airport is serviced by US Air. The bus ser- vice is Greyhound (1-800-231-2222). Arrangements for pick-ups and drop-offs for campers need to be expressed to Jeff Alder at 434-582-2381. The camp is open to any and all entrants (limited only by number, age, grade level and/or gender. * Must register by May 15 to receive a camp ball and T-shirt Session 2: July 15 - July 18, 2013 Group 1 9:00 a.m. - 12:00p.m. Cost: $110.00 - ages 5-10 Group 2 1:00 p.m. - 4:00 p.m. Cost: $110.00 - ages 11-18 Your Balance is Due July 5 The purpose of this camp is to offer the novice and experienced player the opportunity to develop individual and team skills to his or her potential. The goal is to improve each camper’s technical skill level and tactical awareness level. The campers are divided into groups based on age, experience, and ability. These groups rotate among various skill stations during each session where they receive guidance from our coaching staff. Camper Benefits Daily devotions Technical training Tactical training Goalkeeper training Small-sided games Liberty Soccer T-shirt Camp Ball Registration Group 1 8:45 a.m. on 7/15/2013 Group 2 12:45 p.m. on 7/15/2013 Check in at the Thomas Indoor Soccer Center * Must register by June 15 to receive a camp ball and T-shirt. Housing No formal housing arrangements will be made by any camp staff member. For those interested in accom- modations, the Wingate Inn is located next to the LU campus and will offer a discount rate. Supervision must be provided by parents. please contact the wingate inn at 434-845-1700. The camp is open to any and all entrants (limited only by number, age, grade level and/or gender. * There is a $5.00 multi child discount for the 2nd/3rd child that attends camp. * There is a $25.00 discount for the senior camp if your team brings 7 or more players. SENIOR ADVANCED CAMP - FOR BOYS ONLY INDIVIDUAL DAY CAMP - FOR BOYS AND GIRLS MEDICAL INFO 4003 Wards Road Lynchburg, VA. 434-239-2557 Technical training Goalkeeper training 11 vs 11 games Evaluation Camp Ball Parental Consent Form This completed form will enable health facilities in Lynchburg and camp medical staff to provide prompt care to your minor son or daughter. All areas of this form must be completed prior to camp registration. I/We, the undersigned, hereby certify that I/we am/are the parent or legal guardian of the camper. I hereby give permis- sion 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/ we will be responsible for any and all cost of medical attention and treatment. I/We, the undersigned, for ourselves and as guardian(s) of (camper’s name)__________________ understand that soccer is an active, physical sport, and that injuries can take place during play. I/We understand that, as with any sport, injuries can occur, and we hereby admit that our child is physically and mentally capable of participating in soccer and camp activities. I/We represent that I/We have sought the opinion of our child’s pediatrician, ___________________, and he concurs that,__ _____________ is fully capable of safely engaging in these activities. I/We also understand that it is my/our re- sponsibility in caring for the camper listed above, to be assured that he/she is fully capable of engaging in this sports activity, and I/we are confident that he/she is able to engage in such sport. I/We, the undersigned, for ourselves, our heirs, executors and administrators, waive, release and forever discharge Soccer Mania, Jeff Alder and his staff, officers, agents, employees, representatives, successors and assign of and from all rights and claims for damages, injury, or loss to person or property which may be sustained or occur during participation in camp activities or while at camp, whether or not damage, injury, or loss is due to negligence. Signature of parent or guardian _______________________________ Date _____________________ In case of emergency, contact/phone number: Camper’s physician/phone number: Date of last tetanus toxoid: Allergic reactions? Medication presently taking: Past illness or other information that would be useful in the event treatment is necessary: Your insurance company Agents name Policy # Phone # Any instructions regarding your insurance? _____________________/________________ __________________/________________ _____________________ _______________________ ___________________________ _______________________________________ ________________________________ _____________________ ______________________________ ______________________________ _______________________________________________________________ LIBERTY UNIVERSITY AND SOCCER MANIA

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Page 1: LIBERTY UNIVERSITY MEDICAL INFO CAMP INFO AND …€¦ · Please fill out the application and parental consent form and return it with your deposit to reserve your space at camp

Please fill out the application and parental consent form and return it with your deposit to reserve your space at camp.

Session 1Senior Advanced Skills Camp

June 23 - June 27, 2013Boys Grades 8-12

Session 2Individual Day Camp

For Boys and GirlsJuly 15 - 18, 2013

Presents

THE 2013 Jeff Alder

Soccer Camps434-473-9214

Sponsored in part by

CAMP INFOSession 1: June 23 - June 27, 2013Registration and Check in : 5-6 p.m. June 23Camp ends at 12:00 p.m. on Thursday, June 27Your Balance is Due June 13 We do not provide any meals until Monday morning. This camp caters to the high school student who seeks to sharpen his skill level and has a strong interest to play at the collegiate level. The senior advanced camp is open to anyone who is presently in grades 8-12. The camp will give the Student-Athlete the opportunity to be coached and evaluated by the Liberty University soccer staff. Each player will learn about how the College recruiting process works, what college coaches are looking for in a player, and how to better present himself as a college prospect to coaches through the use of resumes, videotapes, etc. Camper Benefits Daily devotionsTactical trainingSmall-sided gamesLiberty Soccer T-shirtCollege recruiting sessions

CostThe cost of the Senior Advanced camp is $400.00 and includes four nights lodging, 10 meals (breakfast on Monday through breakfast on Thursday), and a Liberty Soccer T-shirt. The cost for the day camper is $300.00 and includes lunch and dinner on Monday, Tuesday, and Wednesday, and a Liberty Soccer T-shirt. The coaching staff will be staying with the camp-ers to provide supervision.

TransportationEach Senior advanced Camper is responsible for his own transportation to and from the camp. Lynchburg Regional Airport is serviced by US Air. The bus ser-vice is Greyhound (1-800-231-2222). Arrangements for pick-ups and drop-offs for campers need to be expressed to Jeff Alder at 434-582-2381. The camp is open to any and all entrants (limited only by number, age, grade level and/or gender.

* Must register by May 15 to receive a camp ball and T-shirt

Session 2: July 15 - July 18, 2013 Group 1 9:00 a.m. - 12:00p.m. Cost: $110.00 - ages 5-10 Group 2 1:00 p.m. - 4:00 p.m. Cost: $110.00 - ages 11-18 Your Balance is Due July 5

The purpose of this camp is to offer the novice and experienced player the opportunity to develop individual and team skills to his or her potential. The goal is to improve each camper’s technical skill level and tactical awareness level. The campers are divided into groups based on age, experience, and ability. These groups rotate among various skill stations during each session where they receive guidance from our coaching staff.

Camper BenefitsDaily devotions Technical trainingTactical training Goalkeeper trainingSmall-sided games Liberty Soccer T-shirt Camp Ball

RegistrationGroup 1 8:45 a.m. on 7/15/2013 Group 2 12:45 p.m. on 7/15/2013 Check in at the Thomas Indoor Soccer Center* Must register by June 15 to receive a camp ball and T-shirt.

HousingNo formal housing arrangements will be made by any camp staff member. For those interested in accom-modations, the Wingate Inn is located next to the LU campus and will offer a discount rate. Supervision must be provided by parents. please contact the wingate inn at 434-845-1700. The camp is open to any and all entrants (limited only by number, age, grade level and/or gender.

* There is a $5.00 multi child discount for the 2nd/3rd child that attends camp. * There is a $25.00 discount for the senior camp if your team brings 7 or more players.

SENIOR ADVANCED CAMP - FOR BOYS ONLY INDIVIDUAL DAY CAMP - FOR BOYS AND GIRLS

MEDICAL INFO

4003 Wards Road Lynchburg, VA. 434-239-2557

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LIBERTY UNIVERSITYAND

SOCCER MANIA

Page 2: LIBERTY UNIVERSITY MEDICAL INFO CAMP INFO AND …€¦ · Please fill out the application and parental consent form and return it with your deposit to reserve your space at camp

Liberty University soccer enjoys a rich tradition of success against some of the top soccer programs in the country. The soccer program, built on a foundation of excellent coaching, quality Christian student-athletes, and a challenging training environment, encourages kids to reach their full potential.

The coaching staff is committed to developing the total player and person. Our goal is to see kids grow and

mature academically, athletically, socially, and spiritually. Liberty soccer uses the college experience, both on and

off the field of play, to teach, to prepare and to equip student-athletes for life after soccer. The camp has proven to be a rewarding experience for young soccer players. Our camp curriculum, praised by campers and parents, features intensive instruction from some of the most knowledgeable collegiate coaches in the country. Regardless of skill level or soccer ambition, campers are encouraged and challenged to learn, play, and enjoy the game of soccer.

I would like to extend a personal invitation to you to become a part of our soccer tradition at Liberty Univer-sity. This summer, I look forward to sharing four days of soccer, fun, and fellowship with you. Jeff Alder Head Soccer Coach and Camp Director, [email protected]

CAMP DIRECTORJEFF ALDERJeff Alder just completed his 12th year as Head Men’s Soccer Coach at Liberty University after serving nine years as the top assistant for the men’s team. A native of Atlanta, GA, Coach Alder is a 1991 graduate of Liberty. He was a four year starter who began his college career by earning first team all conference honors and winning the most promising freshman award during the 1987 season. During his senior year, he helped lead the flames to a 12-2-2 record. Alder led Liberty to a Big south Championship in 2007 and 2011 with a 13-5-2 record and an appearance in the NCAA Tournament.

Highlights of Coach Alder’s career include:State of Virginia Olympic development staff coachDirector of coaching for Southwest Virginia Olympic Development programCoached and developed four USA Youth National Team PlayersGuest evaluator for US U-18 National TeamServed on former US National Team Coach, Bruce Arena’s camp staff for three yearsNSCAA National Diploma, Advanced National Diploma, and Premier DiplomaPlayed professional soccer with the Roanoke WrathCoached & Developed 7 MLS draft picks in 8 years

PLEASE COMPLETE BOTH SIDES OF THIS FORM AND RETURN IT WITH THE NON-REFUNDABLE DEPOSIT TO RESERVE YOUR SPACE AT CAMP.

CHECK DESIRED SESSION:SESSION 1: SENIOR ADVANCED CAMP $400.00 (resident) $300.00 (commuter) *Required Deposit - $100.00 __________SESSION 2: INDIVIDUAL DAY CAMP $110.00 Morning Group *Required Deposit - $30.00 ______________ $110.00 Afternoon Group *Required Deposit - $30.00 _______________

Total for soccer camp __________________ Less Deposit amount __________________

Balance due 7 days prior to camp_________

Please return your non-refundable deposit and application to: (Please print or type) Name_____________________________________________Address____________________________________________City______________________ State______ Zip___________Parent’s Name______________________________________Cell Phone_________________________________________Male________ Female________ Age____________T-shirt Size (circle): Adult/Youth (circle) S M L XLHousing information for senior advanced campRoomate Preference_________________________________Please include your email address in order to receive the confirmation letter.Position___________________________________________

E-Mail_____________________________________________

APPLICATION2013 SOCCER CAMP

*Deposit must be received by the deadline in order to receive T-shirt and Camp Ball

Soccer Mania204 Wyndpark Circle Lynchburg, VA 24502

**Please make checks payable to Soccer Mania.

SPONSORS

(434) 385-1080 2264 Lakeside DriveLynchburg, VA 24501Next to Bikes Unlimitedwww.blueridgesocceronline.com

STATE FARM INSURANCE COMPANIES Home offices: Bloomington, Illinois Ray Barnett; Agent7400 Timberlake Rd. Bus. (434) 239 2694 Lynchburg, VA 24502 Fax (434) 239-5541

44 Clifton Street Lynchburg, 24501

434-528-1848

Liberty Discount Available!Call 434-845-1700 or 1-877-494-6429

www.wingate-lynchburg.com

RIVER RIDGE MALL237-5231

Open to any and all entrants limited only by numbers/age and /or gender