University of Maryland Varsity Sports Teamhousejanuary 8Th(Sun 9-4 Pm)$150

2017 Maryland Soccer Winter Elite ID Camp

University of Maryland Varsity Sports TeamhouseJanuary 8th(Sun 9-4 pm)$150

As a reminder you must pay in full the morning of the camp at registration. (Cash or Check made to Jacob Pace)

Email This Registration to:

Name:
Age:
Height:
Weight:
Positions:
Phone:
Email:
Emergency Contact:
Sandwich Choice (Circle): Turkey Ham and Provolone CheeseRoast BeefTuna

Directed by Associate Head Coach and Head Recruiting Coordinator of UMD, Brian Rowland, the Elite ID Camp is designed for high school age players looking to take the next step into the college soccer environment. The cost of camp includes training sessions run by the University of Maryland Soccer Staff and competitive matches (11v11). Campers will compete against other high level athletes, who are also looking to play at the next level. Also included is a recruiting and information lecture on college soccer by the UMD coaches.

*All training sessions will be held on the turf field outside of the Varsity Team House or on the grass practice field. Please check out the directions on our website and UMD Campus map for more information about location and parking.*

Parking Options:

The ID clinic will be held on the turf field next to the UMD Varsity Teamhouse. Some parking restrictions are lifted on the weekends but players/parents need to be aware of where they park. Players/ Parents can park in Lot 1, and Lot Q.Please check out the UMD Campus Mapto see the parking lots where players/parents can park and the restrictions.

Questions?

Email:

Phone- 410-707-4424

Maryland Soccer Medical Form

Camp Date

Location

*Please email to or bring it to camp registration. We CANNOT admit any camper without the completed health form.

Camper's Name Age Wt. Ht.

Address Telephone ______

Medical History (Please circle for YES) German Measles Measles Mumps Asthma

Chicken Pox Pneumonia Diabetes

Immunization HistoryAllergy HistoryDrug Allergy

(include dates if possible)(Yes/No)(Yes/No)

Tetanus ToxoidHay feverSulpha

Polio VaccineAsthmaPenicillin____

Tuberculin TestEczemaAntibiotics

MeaslesInsect StingsOther__

RubellaOther

Mumps

If your child will be taking medication during camp, please indicate name of drug and dosage

Is there any physical activity from which your child should be restricted? If yes, please explain

Physician's Name:

Telephone:

I, the parent of the child named above give permission for my child to receive emergency medical treatment and to be hospitalized if necessary. I understand that every attempt will be made to contact me, or the person named before taking this action. I hereby waive and release all University of Maryland Soccer Coaches and sponsors from any liability for any injury or illness incurred while at camp. I understand that I will be financially responsible for any medical attention needed during the camp.

Emergency Contact: Telephone ( )
Signed ______Date______