Bluffton Soccer Camp - Bluffton Soccer Club

Soccer Camp
Registration Form
Please return by Monday June 29, 2015
Registration is $60 and must be paid in full by
June 29, 2015. Checks should be made out to
Welcome to Pirate Soccer!
The Bluffton Soccer Club and the Bluffton High
School Pirate Soccer Teams have again joined
forces for this spirited summer soccer event.
Our collective goal is to provide for our local
community, a quality soccer education using
best practices and age-appropriate techniques
& tactics—and to have a great time doing it!
Bluffton Soccer Club and designated for
“Soccer Camp.” Each participant will receive a
Bluffton
Soccer Camp
For athletes ages 5-14
July 27-30, 2015
6:00-8:00 p.m.
On the soccer fields at
Citizens National Bank
ball, and camp t-shirt. Late registrants will be
accepted, but there is no guarantee of a camp
ball and/or t-shirt. Family discount: First two
participants from the same family pay the full
rate. Additional participants from the same
family pay only $20. Scholarships are available.
Registrations can be mailed to:
Jared Byers
617 Lausanne Ave.
Bluffton, Ohio 45817
Player Name:
Age:
Birth Date:
/
/
Address:
Phone:
Parent(s) or Guardians:
E-mail:
T-Shirt size:
YS (6-8)
YM (10-12)
YL (14-16)

Adult Small
Adult Medium
Adult Large
Coaching Staff
Steve Smucker
Coach Smucker is the Head Coach of the Bluffton
High School Boys’ team and the Director of Coaching
for the BSC. Among other credentials, he holds an
NSCAA Premier Diploma, a Youth National Diploma
and a USSF “B” License.
Jared Byers
Coach Byers is in his first year as Head Coach of the
Lady Pirates. He has many years of experience with
the Girls’ team and with BSC teams and youth soccer
camps.
Joel Steinmetz
Coach Steinmetz has 16 years of experience coaching soccer at Bluffton High School. He holds an
NSCAA National Diploma and is proud member of
the first BHS Pirates’ Soccer Team.
Hosted by:
Russell Bender
Coach Bender is the Assistant Coach for the Pirates
and an experienced youth coach and camp staff
member.
Additional staff
Additional staff will include the athletes from Bluffton
High School as well as coaching staff from the Bluffton Soccer Club.
Questions?
Contact Coach Steve Smucker
419-890-7316
smuckers@bathwildcats.org
Bluffton
Soccer
Club
Bluffton
High School
Soccer
Bluffton Soccer Camp
Waiver and
Release of All Claims 2014
The purpose of the Bluffton Soccer
Camp is to encourage the skill
development of soccer players in an
affirming environment. The fundamental
skills (dribbling, passing, shooting,
defending, heading) will be covered by
experienced
clinicians
who
will
encourage each player’s development.
This camp will be a great opportunity for
players to fine tune their skills for the fall
soccer season.
Assumption of Risk and Agreement to Participate: As a
participant in the activities or programs of the Bluffton Soccer Club and Bluffton High school soccer team, I recognize
and acknowledge that there are certain risks of physical
injury and I agree to assume the full risk of any injuries,
including death, damages or loss which I or my child may
sustain as a result of participation or use of such facilities,
activities or programs. I agree to look to my private physician
for medical advice and care and to notify instructors of any
physical limitation I or my child may have or modifications
needed. As a participant, I or my child agree(s) to adhere to
rules of the facility and instructional staff or agents.
Waive, Release & Indemnify: I hereby waive, release and
discharge any and all claims I may have or may acquire
against the Bluffton Soccer Club and/or Bluffton High
School, its officers, agents, servants and employees as a
result of my or my child’s participation in the activities and
programs of the Bluffton Soccer Club and Bluffton High
School and I agree to indemnify and hold harmless the Bluffton Soccer Club and Bluffton High School, its officers,
agents, servants and employees from any and all claims
Your child can expect to have a terrific
time playing, competing and learning in
a safe child-centered environment. Creativity and teamwork will be valued in
each individual.
resulting from injuries, damages, and losses, including death,
sustained while I or my child are participating in the Bluffton
Soccer Club and Bluffton High School Soccer Camp, except
Join us!
for willful and wanton misconduct by the Bluffton Soccer
Club and Bluffton High School or its authorized personnel.
I have read and fully understand the above Waiver and
Release of All Claims form.
Signature of participant or guardian (if under 18 yrs)
Date _________________________________________
Mail to: Jared Byers
617 Lausanne Ave.
Bluffton, Ohio 45817