2012 Cougar Soccer Camp

7740 Old U.S. 50, Breese, IL  62230-9702

Phone:  618-363-3678

Dates: July 30 – August 2, 2012; Boys and Girls (will be split up during the camp)

Times: 5:30 – 7:00 p.m. – All kids who will be entering 1^st – 8^th Grade in Fall of 2012. Weather permitting, if two or more sessions are canceled due to weather, a make up session will be held on Saturday.

Location: Central High School Soccer Field

Camp Staff: Central Cougar Coaching Staff and ex-Players.

Cost: $40. The cost for a second member of the same family is $30.

Each participant will receive a camp t-shirt and ball. Must be received by July 13, 2012 to receive ball and shirt at the camp.

Fundamentals: The basic soccer fundamentals will be taught including dribbling, passing, shooting, defending, heading, and playing as a team.

Central Cougar Soccer Camp Application

Name:______________________________________ Grade:_________ Sex: M/F

Address:_____________________________________ Birthdate:___________

City:_____________________ Zip:___________

Phone #:__________________ Emergency Contact #:____________________

Parent Names:________________________________________________________

I, the parent/guardian of __________________________________ give my permission for him to attend the 2011 Cougar Soccer Camp.  I understand that Central High School or the Cougar Soccer Camp DOES NOT provide insurance coverage for any accidental injury sustained by my son/daughter as a result of his participation in the activities of the camp.

Signature:_____________________________ Date:_______________

T-Shirt Size (Circle one):  Childs S M L     Mens  S  M  L  XL

Mail application form and check to:  Cougar Soccer Camp, c/o Matt Cassady,

930 N 4^th Street, Breese, IL  62230

Make checks payable to:  Central High School

Questions: Coach Matt Cassady 618-363-3678 CHScougarsoccer@yahoo.com