21st Annual UTPB Falcon Volleyball Camp Each camp has a limited enrollment. Register today! Pre-registration is preferred. An extra $20 fee will be charged for registration on first day of camp. Falcon Advanced HS Camp: July 6-8 9:00am-Noon Grades 9-12 Pre-registration: $120 Day-of registration: $140* Falcon Advanced HS Camp #2: July 31 (bring sack lunch on Day 1) August 1 Grades 9-12 Pre-registration: $120 9:00am-4:00pm 9:00am-Noon Day-of registration: $140* Falcon Skills MS/Elem Camp #1: July 9-10 9:00am-Noon Grades 5-8 Pre-registration: $80 Day-of registration: $100* Falcon Skills MS/Elem Camp #2: August 5-6 9:00am-Noon Grades 5-8 Pre-registration: $80 Day-of registration: $100* *Late registration is at 8:00am on the first day of camp Falcon Skills Camp is for students entering grades 5-8. The focus of this camp is passing, serving, and basic team play. Spiking, blocking, and emergency defensive skills will be covered to a limited degree. Falcon Advanced HS Camp is designed for students entering grades 9-12. This camp is mentally, as well as physically, challenging. Advanced skills are emphasized (quick sets, blocking, team play etc.) Considerable time is dedicated to the athlete’s specialty position. Why Attend the UTPB Falcon Camp? Individual attention is given to all campers Small sided and full scrimmages are included Campers meet players from other schools College coaches run camp All players receive a T-Shirt & Season Pass for all Falcon Volleyball Home Matches in 2015 ($50 value) Lots of Reps/Contacts each day Assistant Coach and Camp Director, Melissa Lusk Melissa Lusk enters her second season as the assistant volleyball coach at UTPB. Lusk was a four-year player for UTPB from 2010-2014. She was a three-time Heartland Conference first-team selection during her time at UTPB. For more information about Falcon Volleyball Camp: Email: [email protected] Call: (432) 552-4680 Head Coach, Tim Loesch Tim Loesch enters his first year as head volleyball coach at UTPB. Loesch comes to UTPB having most recently spent three seasons as head indoor and sand coach at Division I Stetson in DeLand, Florida. In 2013, Loesch helped lead the Hatters to an 18-16 record and the program's first appearance in the Atlantic Sun tournament since 1995. Stetson's nine conference victories broke the school record, and the team's seven-match winning streak was the longest in 27 years. Loesch's first indoor season in fall of 2011 saw the Hatters win nine matches, more than their previous three seasons combined. Loesch arrived at Stetson from NCAA Division II Limestone College (Gaffney, S.C.) where he served seven seasons as the head coach for their women's volleyball team. He also established the men's varsity volleyball program at Limestone. 21st Annual UTPB Falcon Volleyball Camp Camper: Name: Check each camp that will be attended. _______ Address: Falcon Advanced HS Camp #1 Pre-registration $120 City: (July 6-8 for grades 9-12) Day-of registration $140 Falcon Advanced HS Camp #2 Pre-registration $120 (July 31-Aug 1 for grades 9-12) Day-of registration $140 Falcon Skills MS/El Camp #1 Pre-registration $80 (July 9-10 for grades 5-8) Day-of registration $100 Falcon Skills MS/El Camp #2 Pre-registration $80 (August 5-6 for grades 5-8) Day-of registration $100 State: Zip: Camper’s email: Grade camper will enter in the Fall___________ School__________________________________ T-shirt Size YM AS AM AL Legal Guardian: Name:___________________________________ E-mail:___________________________________ Cell Phone:______________________________ Total amount due: $ Cell/Work Phone:___________________________ If you will be staying on campus during your camper’s sessions – or your camper will be driving herself – we must get a free, temporary parking pass for you. Please provide the following data: Driver’s name: _ Owner of vehicle: _ Year/Make/Model of vehicle: _ Vehicle license plate number: _ Payments Accepted: Check, cash, or money order Make checks payable to UTPB Volleyball Return This Form & Payment to : UTPB Volleyball Camp 4901 E University Blvd Odessa, TX 79762 UTPB Liability Waiver MUST be completed and signed Medical Information: Medical Insurance Co.__________________________ Policy Number________________________________ Family Doctor_________________________________ Family Doctor Phone___________________________ Does the camper have any physical limitations? No - Yes (If yes, please list on a separate sheet of paper.) I am the Parent/Guardian of the above participant, who is under eighteen years of age — or the participant who is eighteen years of age or older. I am fully competent to sign this Agreement. I give permission for Participant to participate in the above-referenced Activity. I acknowledge that the nature of the Activity may expose Participant to hazards or risks that may result in Participant’s illness, personal injury or death and I understand and appreciate the nature of such hazards and risks. In consideration of Participant being permitted to participate in the Activity, I hereby accept all risk to Participant’s health and/or his/her injury or death that may result from such participation and I hereby release the above named Institution, its governing board, officers, employees and representatives from any and all liability to Participant, Participant’s personal representatives, estate, heirs, next of kin, and assigns for any and all claims and causes of action for loss of or damage to Participant’s property and for any and all illness or injury to Participant’s person, including his/her death, that may result from or occur during Participant’s participation in the Activity, whether caused by negligence of the Institution, its governing board, officers, employees, or representatives, or otherwise. I further agree to indemnify and hold harmless the Institution and its governing board, officers, employees, and representatives from liability for the injury or death of any person(s) and/or damage to property that may result from Participant’s negligent or intentional act or omission while participating in the described Activity. I have carefully read this agreement and understand it to be a release of all claims and causes of action for participant’s injury or death or damage to participant’s property that occurs while participating in the described activity and it obligates me to indemnify the parties named for any liability for injury or death or any person and damage to property caused by participant’s negligent or intentional act or omission. _______________________________________________________ Printed Name _______________________________________________________ Signature Emergency Phone: _______________________________________________________ Date
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