KETTLE RUN SOCCER CLINIC When: Saturday, Feb. 19th Time: 9-2:30 Cost: $35 Who: Anyone grades 7-12 that would like to get a head start on the spring soccer season! Return With Payment: Name:______________________________ Grade:______________________________ T-Shirt Size: S M L XL Address:_______________________________________________________________ Phone:_____________________________ Email:______________________________ Make Check Payable To: KETTLE RUN HIGH SCHOOL Forms must be received by 2/10/11!! PARENT/GUARDIAN AUTHORIZATION: My son or daughter is physically capable of participating in the clinic and I hereby approve of my child’s participation in the clinic. I authorize the sports medicine trainer and directors to act for me using their best judgment in an emergency requiring medical attention, for which service I agree to pay. Please attach a note explaining any physical limitations and/or conditions requiring medication. __________________________________________ Parent Signature PERSON TO CONTACT IN CASE OF EMERGENCY: NAME:_____________________________ PHONE/CELL:________________________ How To Enroll Complete and return this form along with payment to: Philip Roper 7403 Academic Avenue Nokesville, VA 20181 Forms must be received by 2/10/11 in order to attend the clinic. FEES: $35 – checks/money orders made payable to Kettle Run High School c/o Soccer Clinic * price includes clinic t-shirt What To Bring *Bag lunch (drink and/or snack) *Cleats and shin guards *Indoor shoes if forced indoors due to inclement weather *Positive Attitude Questions?? Contact Philip Roper: Phone: 540 422-7330 ext. 3054 Email: proper@fcps1.org Items of Interest Clinic will be broken down into 2 segments: * 9-11:30 Technical skills and strategies of the game (goalkeeper training will also be available) * 11:30-12 Lunch * 12-2:30 Small-sided games Athletic Trainer on staff Morning Drop-off Players are to be dropped off on the KRHS bus loop for check-in between 8:30 and 9:00