Summer Soccer Academy 2012

Mid Carolina High School
Summer Soccer Academy 2012
Mid Carolina High School presents the 2012 Summer Soccer Academy for boys & girls.

Where: Mid Carolina Soccer Fields
When: June 11th to 15th Time: All Grades 2-12 from 9am to 11am
Cost: $35 per child and this includes a free t-shirt (Checks can be made to MCHS) Please register by May 25th to ensure that you will receive a t-shirt. Registration will also be taken after this date.

For questions please contact Heather Mann at (803)364-3634 or by email at hmann@newberry.k12.sc.us

This Summer academy will teach your child the basic foundations of soccer with skill work, fun training games and an end of week tournament. The older grades will learn more intensive training techniques that will help them for their future athletic endeavors. The MCHS girls JV & V soccer teams will be coaching your child along with the JV & V soccer coaches, Jessica Stalker & Heather Mann.


Participant’s Name: ________________________________ Date of Birth: ___/____/______ Age: ____ Grade: ____ Name: Father’s: _____________________ Mother’s: ______________________ Legal Guardian: _____________________ Mailing Address: _____________________________________ City: ________________ State: _____ Zip: ________ Home Phone: _____________ Work: _____________ Cell: _______________ Email: ____________________________ Name of Insurance Co: __________________________________ Policy/Card #: _______________ Phone: _____________

Participant Shirt Size: YS YM YL AS AM AL AXL

In signing up and participating in this Camp, you are expressly assuming the risk and legal liability and waiving and releasing all claims for injuries, damages or loss which you might sustain as a result of participating in any and all activities, including transportation services, where provided. I acknowledge that there are certain risks of physical injury to participants in these programs and I voluntarily agree to assume the full risk of any and all injuries, damages or loss, regardless of severity, that I/my child may sustain as a result of participation. I further agree to waive and relinquish all claims I/my child may have as a result of participating in these programs against the County of Newberry, the Newberry County School District, and its, officials, agents, volunteers, sponsors, and employees. If my child is injured, becomes ill, or needs medical attention for any reason, I authorize program staff/volunteer coaches to assist my child and to call for medical assistance. My child will be transported to the nearest medical facility as determined by emergency personnel. I understand I am responsible for my own medical coverage and all costs incurred in any such medical emergency. I understand photographs of my child’s participation in this program may be used by County of Newberry to promote the County’s events, without compen-sation and without additional approval. I HAVE READ AND FULLY UNDERSTAND THIS WAVIER. Parent or Legal Guardians Signature: ____________________________________________ Date: __________________