SOCCER CAMPS - FALL 2014 -

Disclaimer AND Signature

I hereby grant permission as a parent or authorized guardian for my child to attend Coach Kickken Soccer, Inc. (herein CKS) and to be treated by a licensed physician in the event of an injury, accident, illness or other mishap during the course of participation. I understand that CKS will not be held responsible for personal injury occurring as a result of CKS participation. I also understand that insurance will not be provided by CKS and I agree to provide my own. Therefore, I will be fully responsible for any medical or other charges in connection with my childs attendance of CKS. I hereby release CKS, its agents and its employees from any and all liability arising from injury, loss or death of my child that may occur while participating in CKS.

Signature: ______________________________________

Date: ____________________

HOW TO PAY

Please make all checks payable to:

Coach Kickken Soccer

Contact Coach Kickken at:

Jack@CoachKickken.com (251) 895-2389

Find Us Online at: http://www.CoachKickken.com

On Facebook at: http://www.facebook.com/CoachKickkenSoccer

COACH KICKKEN SOCCER, INC. PO BOX 501199

MOBILE, AL 36605

Register YOUR CHILD

Parent/Guardian Name: ________________________________________

Address:

________________________________________

City: State: Zip: ____________________ _____ ________

Home Phone: Cell/Alt. Phone: ____________________ ________________

E-mail: ________________________________________

Childs Name: ________________________________________

Age: Gender: ____________ _____________

Date of Birth: T-Shirt Size: ___/___/____ _____________

GOT SOCCER?

About Coach Kickken Soccer

About Coach Kickken Soccer

Coach Kickken Soccer teaches kids and teens basic soccer skills through fun drills and enjoyable games. These drills are designed to teach the fundamentals of soccer in an enjoyable, positive environment that is geared to keep kids focused, engaged and entertained.

Your kids will get a great workout! Because sessions are limited, your childs skill and potential will improve sooner due to maximized touches on the ball and a certified instructor focused on technique and detail. This is necessary attention needed to achieve your soccer goals.

Coach Kickken Soccer will help your child or teen develop skills that will enable them to easily transition into more competitive leagues as they grow up.

Coach Kickken Soccers unique approach to soccer skill development gives your child the confidence they need to explore the game of soccer in a supportive, safe environment.

Skills Covered

Each session will cover the same basic skills, however the curriculum is set up uniquely for each individual session. We encourage parents or guardians to sign up their kids for more than just one camp. Only one registration is required.

About COACH JACK KICKKEN

Coach Kickken grew up in The Netherlands and came to the US in 2002. During and after his playing career, he has successfully coached youth teams at all kinds of different levels. He was the head coach of St. Luke's Episcopal School boys' soccer program, he coached at St. Paul's Episcopal School and at the Mobile Soccer Club. Coach Kickken is married to Christie Jo and they have a son named Jeremy. He previously was the head coach of Greene County High School Boys and Girls Soccer and the Head Coach of St. Lukes.

PRACTICE MAKES PERFECT!

Coach Kickken Fall Camp is for children ages 3 to 8. Practice sessions are provided during September 13th through November 15th.

LOCATION AND COSTS

Fall 2014 Camp Field Location:

9565 Scott Dairy Loop Rd. S., Mobile, AL 36695

The costs are as follows:

Ages 3-4: $95.00 for 10 weeks

Ages 5-6: $95.00 for 10 weeks

Ages 7-8: $125.00 for 10 weeks

Costs include a free t-shirt!

Practice Session Times

Ages 3 to 4

Saturday 9:00AM - 9:45AM

Ages 5 to 6

Saturday 10:00AM - 10:45AM

Ages 7 to 8

Saturday 11:00AM - 12:00PM