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 Register Online: http://www.northsouthsoccercamps.com Grades: Kindergarten – 8th Grade (Fall of ’15) boys or girls Dates: Session 1 – Mon – Thu, June 8th – 11th, 8:30 – 11:00AM Session 2 – Mon – Thu, June 15th – 18th, 8:30 – 11:00AM *Sessions I & II follow the same soccer curriculum Cost: Includes age appropriate ball and Camp T-­‐Shirt Single Session Both Sessions # of children per family Cost per Child # of children per family Cost per Child 1 $90 1 $150 2+ $80 2+ $130 Where: Elkhorn High School Soccer Stadium 1401 Veterans Drive Elkhorn, NE 68022 Instruction: Coaches and players from both the Elkhorn Antler & Elkhorn South Storm soccer programs will provide soccer instruction Overview: North-­‐South Soccer Camps are designed to provide quality instruction; expose kids to a level of soccer commensurate to their abilities and interest, and create a positive learning environment. We encourage players from various backgrounds and abilities to attend, as the majority of each session will be individual skills training progressing to small-­‐sided games. Camp is designed to help players learn and improve their basic soccer skills and techniques through age appropriate training and enjoyable games. The emphasis of the camp is on FUN. Campers will be divided into groups by grade (Level I: grades K-­‐1, Level II: grades 2-­‐3, Level III: grades 4-­‐5, Level IV: grades 6-­‐8). Age groups will be directed by one of Elkhorn High/Elkhorn South soccer coaches. Current and former Antler/Storm players from the boy’s and girl’s teams will complete the staff, providing a coach to a camper ratio of approximately 1 to 8. Every player will have the opportunity to learn from our student-­‐athletes and be coached by professional coaches. The engaging, scaffold format will help all players improve their individual skills and love of soccer. Mail To: North South Soccer Camps c
/o Troy Stoller 4132 N. 174th Ave Omaha, NE 68116 NORTH SOUTH SOCCER CAMPS Player Registration Player Name: ________________________________________ Gender: M – F Grade: ____ (Fall ’15) DOB: ____/____/____ Current School: ______________________________ T-­‐Shirts size: (circle one) YS – YM – YL – YXL – AS – AM – AL – AXL Ball Size: (circle one) 3 – 4 – 5 Session: (circle one) Session I (6/8-­‐11) – Session II (6/15-­‐18) – Sessions I & II Parent/Guardian Name: ____________________________________ Mailing Address: ____________________________________ ___________________________________ City: ____________________ State: _____ Zip: _________ Phone: (_____) _____ -­‐ _______ 2nd Phone: (_____) _____ -­‐ _______ Email: _____________________________________@ ____________________ 2nd Email: _____________________________________@ ____________________ Emergency Contact Info: Name: __________________________________ Phone: (_____) _____ -­‐ _______ Relationship to player: _____________________ *If registering multiple players in the same household, please complete a separate registration for each player WAIVER AND RELEASES
I understand that there are risks involved with my child’s participation at the North-South Soccer Camps, LLC.
I hereby authorize the directors of North-South Soccer Camps, LLC. to act for me according to their best judgment in any emergency
requiring medical attention. I hereby waive and release the directors of North-South Soccer Camps, LLC. from all liability and agree to
accept all medical expenses incurred. I know of no physical or mental problem that will affect my child’s ability to safely participate in this
camp. Dismissal due to disciplinary action will result in no refund. I acknowledge and accept the conditions above with my signature below.
I certify that my child is in good health, and may participate in strenuous physical activities at the camp. I certify that there are no physical
limitations to my child’s participation in the camp. Permission is granted for my child to receive emergency medical treatment if needed. I
hereby release and forever discharge North-South Soccer Camps, LLC. the Camp, and all their agents, employees and affiliated entities
from any and all liability, claims, demands, and cause of action for personal injury or death, property damage, and/or other loss suffered by
my child in connection with his/her participation in the Camp. I acknowledge and accept that this Release and Waiver is intended to be
binding on the family, estate, heirs, executors, administrators and assigns of the minor named above. I further acknowledge and accept
that this Release and Waiver is intended to be as broad and inclusive as permitted by the laws of the state in which the Camp is taking
place and agree that if any portion of this release and Waiver is invalid, the remainder will continue to be in full force and effect. I agree
that this Release and Waiver binds the minor and me to all of its terms.
I waive and release the Elkhorn Public Schools, the EPS School Board, and their heirs, assigns or successors in interest of any and each
of them from any and all liability which may result or arise from either my child’s athletics participation or any medical treatment my child
may receive.
_______________________________________ _____/_____/_____ PARENT/GUADIAN SIGNATURE DATE