brochure

Birthday (M/D/Y)������������������������������������������
Insurance Company����������������������������������������
Policy/Group No.������������������������������������������
MEDICAL INFORMATION
Allergic reactions������������������������������������������
Medication presently taking���������������������������������
Past illness or other information
that would be useful in the ­
event treatment is necessary��������������������������������
��������������������������������������������������������
��������������������������������������������������������
EMERGENCY NUMBERS
Father’s Full Name�����������������������������������������
Father’s Phone (home)_________________ (cell)�����������������
Mother’s Full Name����������������������������������������
Mother’s Phone (home)________________ (cell)�����������������
Name and phone # to call if parents cannot be reached:
��������������������������������������������������������
Please check one of the following options and sign:
 I grant permission to the director, assistants, or other persons
responsible for his/her care to act on my behalf for said minor
in granting permission for evaluation and treatment of ­medical
problems. I understand that should a major medical problem
arise, an attempt will be made to notify me by telephone. In
the event that I cannot be reached, I hereby give my consent to
such treatment as deemed necessary (including surgery, X-ray
examinations and anesthesia to be rendered to said minor by a
licensed physician or nurse.)
 I authorize limited care as follows:�������������������������
������������������������������������������������������
������������������������������������������������������
������������������������������������������������������
I, ������������������������������������ , declare that I am the
(circle one) father /mother /guardian of the above named minor.
Parent/Guardian
Signature�������������������������������� Date____________
Jeff Bowers
Jeff Bowers, the head women’s soccer
coach at Virginia Wesleyan College has
compiled an overall record of 237-73-32
with the Marlins and has received
numerous accolades, including 2005
Old Dominion Athletic Conference
Coach of the Year honors as well
as South Region Coach of the Year
honors in 2003 and 2005.
He guided the Marlins to their most successful
season ever in 2006, highlighted by an Old Dominion
Conference Championship and a Final Four NCAA finish. He
also coached the semi-professional Hampton Road Piranhas,
in 2004 and 2005. Bowers holds a Premier License from the
National Soccer Coaches Association of America and a “B”
license from the United States Soccer Federation.
MARLIN SOCCER ACADEMY
Minor’s Name���������������������������������������������
at Virginia Wesleyan College
To provide prompt care to your minor son or daughter, we must
have a new completed consent form on file each year. This way, we
can help your child without any delay in an ­emergency.
Meet the Camp
Directors
Jeff Bowers, Director
Virginia Wesleyan College
1584 Wesleyan Drive
Norfolk, VA 23502-5599
PARENTAL CONSENT FORM
LARGEST SOCCER CAMP IN
HAMPTON ROADS
MARLIN SOCCER
ACADEMY
2016 Soccer Camps
ALL LEVELS • BOYS & GIRLS • AGES 6-15
Last Year: 300 campers in BOTH sessions!
at Virginia Wesleyan College
2016 SOCCER CAMP
Our Philosophy
Marlin Soccer Academy is committed to fostering the “love of
the game” while developing technical, tactical and physical
skills that will enable players to respond to the challenges of
soccer in a confident and creative manner.
About our Camps
Camp Directors Jeff Bowers and Chris Mills will be assisted
by nationally licensed coaches and Virginia Wesleyan players
selected primarily for their ability to relate with and teach
youth players. Emphasis is on individual training as well as
teamwork. Each camper will receive a written evaluation at
the end of the camp.
Day Camps are available to players ages 6 to 15 at all skill
levels and offer a positive overall experience in a fun yet
challenging atmosphere. Players will be grouped by age and
ability.
Chris Mills
Chris Mills has a 36-15-8 record in his first
three years as head men’s soccer coach
at Virginia Wesleyan College. A Virginia
Beach native, he has been a part of the
VWC program as a player and coach
since 2002. He was a part of the 2007
Sweet Sixteen team that was the most
successful in program history. As head
coach, he led the Marlins to their best record since 2007, the
ODAC Conference Championship, and an NCAA tournament
berth in 2013. In his tenure as head coach, Mills has produced
ODAC and Virginia rookies of the year, All-region and AllVirginia honorees, and has been named ODAC Coach of the
Year.
A 2006 Virginia Wesleyan graduate with a major in Recreation
and Leisure Studies, Mills was a standout defensive player
for the Marlins. He was a three-time All-ODAC Conference
honoree and two-time All-Virginia honoree, helping lead the
team to an overall record of 57-17-5, a 27-7-2 ODAC mark,
and two NCAA appearances. Mills holds an Advanced National
Coaching License from the National Soccer Coaches Association
of America.
MARLIN SOCCER
ACADEMY
Goalkeepers will receive specialized instruction each day.
July 11-15
Day Camp Session I
July 25-29
Day Camp Session II
AGES 3-5
Facilities
Virginia Wesleyan College is located on a beautiful 300-acre
wooded campus. The soccer facilities consist of a Bermuda
game field and four practice fields, all exceptionally well
maintained. Within 20 minutes are the famous Virginia
Beach resort areas and beaches. Open to our campers is the
state-of-the-art Batten Student Center which includes:
• Elevated Indoor Track
• Basketball Courts
• Racquetball Courts
• Fitness Center
• Indoor Soccer
• Indoor Swimming Pool
M a rl i n S o cce r Ac a d e my
AGES 3-5
Enroll Two Ways:
Day Camps (ages 6-15)
Session I:
July 11-15, 9:00–3:00
1. Go to: marlin-soccer-academy.com/virginia-soccer-camps
Each Soccer Shots session incorporates the following:
• Basic soccer skills
• Exclusive Soccer Shots games
• Word of the day
• Use of imagination
• Fun fitness activities and exercises
• Coordination, balance and agility development
No gear needed! All soccer equipment is
provided to program participants.
2. Click “Register Now” for Session I or II
4. Submit your payment
Brochure Application
1.Complete the application and
parental consent form.
Registration is on Monday at 8:30 a.m. and the
Closing ceremony is on Friday at 2:30 p.m.
Sun. Mon. Tue. Wed. Thu.
June
https://www.soccershots.org/virginiabeach/
Visit and “Like” us on Facebook at:
www.facebook.com/SoccerShots.VirginiaBeach.VA
LIMITED AVAILABILITY; REGISTER NOW!
TO RESERVE YOUR CHILD’S SPOT
Online registration
Session II:
July 25-29, 9:00–3:00
Register NOW online at:
All children ages 3-5
Virginia Wesleyan College
July 11th – 15th 9:30-11:30 or
July 25th – 29th 9:30-11:30
$100 includes T-Shirt and Camp Certificate
Register online at
https://www.soccershots.org/virginiabeach/
Laura Koontz at lkoontz@soccershots.org
or (757) 377-5986
ENROLLMENT INFORMATION
Marlin Soccer
Academy Schedule
3. Submit your details
Soccer Shots® is a uniquely designed program that
will introduce soccer to your child in a fun, safe and
controlled environment. We offer soccer sessions
where we teach basic soccer skills, fun games and
healthy competition to your child. Our program
also emphasizes character-forming lessons such as
fair play, individual concentration, cooperation and
encouragement.
Who: Where:
When:
Cost:
How:
Contact:
Ag es 6-15
July
August
Fri.
Sat.
26
27
28
29
30
1
2
3
4
5
6
7
8
9
10
11 12 13 14 15
16
17
18
22
23
24
25 26 27 28 29
30
31
1
6
19
2
20
3
21
4
5
Friends/Team/Sibling Team Request
To ensure having your child grouped in the same team,
please place a request on the on-line notes column
or when registering your child.
2016 Corporate Sponsor
Pick Up Policy
At the end of each day campers and parents will
meet at the Trinder Center (Soccer Stadium)
What to Bring
 Soccer cleats
 Water bottle
 Shin guards
 Indoor shoes
 Towel
 Toiletries
 Sunblock
 Bathing Suit
Swimming for campers will vary between 8:00
and 10:00 am Tuesday through Friday
2.Include a $50 check or deposit
money order payable to: “Marlin Soccer Academy”
3. Mail application with payment to:
Jeff Bowers
Virginia Wesleyan College
1584 Wesleyan Drive
Norfolk, VA 23502-5599
4. Team Discount: Teams of ten or more receive a $25.00
discount. Please include team names, team roster and
applications sent in one envelope with your team contact.
To hold your spot, you may also fax your application and
•
•
consent form to: (757) 461-2262
YOUR CLEARED CHECK OR ONLINE CREDIT CARD PAYMENT
CONFIRMS YOUR ENROLLMENT.
E-MAIL CONFIRMATION UPON RECEIVED APPLICATION.
Medical Insurance
Although a physical examination is not required, each
player must have a completed parental consent form on file
(located on the reverse side of the application).
Fees/Deposit
The fee is $235 per camp. A $50 non-refundable deposit is
charged for each player and must be submitted with the
application. The balance is due at registration. The fee includes
a T-shirt, evaluation, camp ball and lunch on Friday.
Cancellation/Refund Policy
If a player is unable to attend camp, please notify us at least 10
days before the start date. Fees will be refunded minus the $50
non-refundable deposit. Once the camp begins, there are no
refunds.
Trainer
An Athletic Trainer will be on-site all week.
MARLIN SOCCER
ACADEMY
at Virginia Wesleyan College
2016 SOCCER CAMP APPLICATION
Please complete the Parental Consent form on the back of this application.
Name����������������������������������������������
Address��������������������������������������������
City���������������������� State_______ Zip__________
Date of Birth������������������ Age on 7/1/16__________
Parent/Guardian�������������������������������������
Parent/Guardian Phone (home) ������������������������
(work)�������������������������
Parent/Guardian
E-mail���������������������������������������������
Shirt Size (circle): Youth S M L Adult S M L XL Please select Camp(s) – $235 Full Day
 Day Camp Session I – July 11 -15
 Day Camp Session II – July 25 - 29
Please select Position(s)
 Field Player
 Goalkeeper
 Combination Field / Goalkeeper
Team Discount (10 or more players) – $25 per player
Team Name�����������������������������������������
Deposit: A $50 non-refundable deposit is charged per player and must
accompany this application with the balance to be paid at registration. For
team discounts, the deposits must be submitted as a group four weeks prior
to the camp start date.
Cancellation/Refund Policy: If a player is unable to attend camp, the ­player
will be charged the $50 non-refundable deposit and the balance of the
payment will be refunded. Once the camp begins, there are no refunds.
Make checks payable to:
Mail application with check to:
Marlin Soccer Academy
Jeff Bowers
Virginia Wesleyan College
1584 Wesleyan Drive
Norfolk, VA 23502-5599
Or, to hold your spot, fax to:
(757) 461-2262
For more information, contact our Camp Directors:
Lunch
Campers bring their lunch Monday-Thursday.
Friday we will have pizza provided!!
Jeff Bowers – (757) 455-3285 / jeff@marlin-soccer-academy.com
Chris Mills – (757) 455-3120 / jeff@marlin-soccer-academy.com
Visit our website at http://www.marlin-soccer-academy.com