non-profit org. U.S. Postage PAID Clarion, PA Permit No. 2 Kids Camps Kids Day Camp Clarion University 2009 Athletic Camps June 8-12 This camp is designed for elementary school-aged children: boys and girls are encouraged to attend. The commuter camp will include a variety of outdoor fun games, swimming, and movies from 9 a.m.-3 p.m. at the main campus of Clarion University, Clarion, PA. Cost is $125 with a $25 deposit required. Kids Introductory Youth Football Day Camp July 6-10 This camp is suggested for children just beginning football or who feel they need more work on basic skills. We will cover positions, stances, starts, throwing, catching, offensive ball handling, blocking, and tackling. It is intended to teach safe techniques in a non-contact, non-threatening environment. Camp will be held at Clarion University Venango Campus in Oil City, PA. The commuter camp runs from 9 a.m.- 11:30 a.m. Cost is $100 with a $25 deposit required. This is a FOOTBALL camp for aspiring young football players. Prior football background is recommended but not required. The youth league camp is designed to work with young athletes to improve basic football skills, from blocking and tackling, to throwing and catching, along with the basic reads, exchanges, and techniques necessary to be a successful football player. Clarion University is located off I-80, Exit 64. NEW YORK PENNSYLVANIA 32 2 Franklin Interstate OHIO Interstate 81 Erie Clarion University 80 Clarion Scranton Williamsport Interstate 80 Interstate 80 3 6 322 Pittsburgh 9 21 Johnstown PA Turnpike WEST VIRGINIA 220 State College 322 rs tate Inte NE Ext. PA Turnpike Youth Camps Midget league programs are encouraged to bring their teams. Cost is $225 for overnight campers and $200 for commuter campers with a $50 deposit required. The camp runs for three days and two nights and will consist of six practices, three offense and three defense. Interstate 79 Great Gift Idea! July 15-17 220 Football Youth Camps Clarion University of Pennsylvania 840 Wood Street Clarion, PA 16214-1232 Midget League Camp 81 Altoona PA Turnpike Allentown PA Turnp ike Harrisburg Philadelphia 322 www.clarion.edu
The Camp The non-contact camp stresses football fundamentals. College and high school coaches introduce the team concept in small groups and teach a specific position on both offense and defense. Athletes practice with players from their own age bracket. Benefits include: l A safe environment l One-on-one instruction l 24-hour supervision l Recreation center The Staff l Camp T-shirt l Film l Swimming pool Jay Foster Coach Foster has completed his third season as head football coach at Clarion University after 18 seasons at Slippery Rock University where he was the defensive coordinator. In 2002, he was a National AFLAC Assistant Coach of the Year finalist along with being an AFCA Division II finalist for Assistant Coach of the Year. Coach Foster has been part of 11 post-season games, seven of which were NCAA national playoff games. He has won four PSAC-West titles, two PSAC East titles, five Division III Conference Championships, and two Meadowlands Cups (awarded to the number-one team in the east). He begins his 16 th year running summer camps and his 13 th year running youth camps. Dave Durish Coach Durish is the offensive coordinator. He is in his fourth stint with the Golden Eagles, serving on the staff from 93-95 and also from 97-98. He is a coaching veteran who has experience on both sides of the ball. Before returning to Clarion, Durish spent time at Case Western Reserve University, Milikin University, University of Illinois, and Georgia Southern University. What to Bring l Everyday clothes l Toilet articles l Linens/Pillow l Fan l Towels/washcloths l Spending money l Swimwear l Playing clothes: T-shirt, gym shorts, athletic socks and supporters, football and tennis shoes Accommodations Resident campers are housed two per room. If you have a roommate preference, be sure to indicate it on your enrollment application. Otherwise, roommates are assigned by age group or hometown. Campers have constant supervision, with coaches and counselors in residence on each floor of the dorm. Medical Facilities Medical services are provided by the Clarion University sports medicine staff. In case of emergency, Clarion Hospital is located within three miles of the university. Dwayne Martin Coach Martin is the defensive coordinator. Prior to Clarion, he spent four seasons at Slippery Rock University coaching linebackers. Before that, he spent three years at Wesley College (Del.) as an assistant, coaching the secondary and running backs. Prior to Wesley, he spent two years as the defensive coordinator at West Virginia Tech. Martin started his coaching career as a student assistant at his alma mater, West Virginia Wesleyan, where he earned four varsity letters and was a three-time all conference selection. Chris Weibel Coach Weibel coaches quarterbacks for the Golden Eagles. He coached at Moniteau High School in 2002-2003 where he was offensive coordinator. Weibel was an All-American quarterback at Clarion (1993-1998), helping lead the Golden Eagles to a Final Four appearance in 1996. He had played in the Arena Football League for five years before returning to Clarion to coach in 2004. 1/09 Name Age Weight Grade (September 2009) Home telephone number Name of school Roommate preference (if any) Position It is the policy of Clarion University of Pennsylvania that there shall be equal opportunity in all of its educational programs, services, and benefits, and there shall be no discrimination with regard to a student s or prospective student s race, color, religion, sex, national origin, disability, age, sexual orientation/affection, veteran status or other classifications that are protected under local, state, and federal laws. Direct equal opportunity inquiries to Assistant to the President for Social Equity, Clarion University of Pennsylvania, 207 Carrier Administration Building, Clarion, PA 16214-1232, 814-393-2109. E-mail Check T-shirt size: q small q medium q large q extra large q extra extra large (youth sizes) m Kids Day Camp m Kids Introductory Camp m Midget League Camp June 8-12 July 6-10 July 15-17 q $125 $25 deposit* q $100 $25 deposit* q Overnight $225 $50 deposit* q Commuter $200 $50 deposit* All checks (money orders preferred) must be made payable to Clarion University of Pennsylvania Payment Type: q Check q Money Order Mail to: Check Number Clarion University Football Camp Clarion University of Pennsylvania, 840 Wood Street, Clarion, PA 16214-1232 Additional Information: Coach Durish, 814-393-1803 Football Office, 814-393-2258 Physical examination will not be required I hereby authorize the director of Clarion Football Camp to act in his best judgment in any emergency requiring medical assistance. I certify my son/daughter has no injury or illness which could jeopardize his well-being by participating in the Football Camp at Clarion University. Parent or guardian must sign CLARION UNIVERSITY OF PENNSYLVANIA 2009 Youth Football Camp Application Please complete the application carefully. Your acceptance may be delayed if information is incomplete. Please enroll me in the Golden Eagles Football Camp. It is understood that Clarion University, the directors, or anyone connected with the school will not assume any responsibility for accidents, medical or dental, or any other expenses incurred as a result of accidents. Please duplicate this application and give to your friends. Street City State Zip Area Code * Deposit is non-refundable.
Informed Consent Release and Express Assumption Risk I,, Parent or Guardian of (Name of Parent or Guardian) (Name of Child) desire for my child to participate in Sports Camp at Clarion University on. (s) I realize injuries can be a consequence or participation in this activity and no amount of reasonable supervision or use of the facility will prevent injury. I appreciate the character of the risk involved and I voluntarily assume on behalf of my child all risk of possible death, harm or injury. I understand and appreciate that such injury could also include, without limitation, serious or permanent injuries to all bodily organs and functions. I am aware of the risk of participation in this designed activity. I have carefully considered how the possible consequences of injury may impact my child s life, and I choose to accept this risk and allow him/her to participate in the designated activity. In accepting this risk, I expressly and explicitly release, discharge and waive any and all responsibility of Clarion University Foundation, Inc., Clarion University of Pennsylvania, Pennsylvania s State System of Higher Education, the Commonwealth of Pennsylvania and the employees, officials or agents of any and all of the foregoing, pursuant or pertaining or related to, or arising from, in any manner, injuries to my child as a result of his/her participation in this activity. By my signature below, I certify that I completely understand this document. Signature of Parent of Guardian Witness
Summer Sports Camp Medical Information Name of Athlete Telephone ( ) Please check camp(s) you plan to attend (M: men, W: women, I: individual, T: team) q Baseball q Basketball: MI q Basketball: MT q Basketball: WI q Basketball: WT q Cross Country q Diving q Football: Kids q Football: Midget q Football: Youth q Football: T q Football: 7-on-7 q Soccer: I q Soccer: Goal q Soccer: T q Softball q Swimming q Tennis: Day q Tennis/Swim q Tennis Tourney q Volleyball: I q Volleyball: Set. q Volleyball: Spec. q Volleyball: T q Wrestling: Fund. q Wrestling: Elite q Wrestling: ST 1 q Wrestling: ST 2 q Wrestling: T q Wrestling: F/S (s) Attending Camp: From / / to / / From / / to / / COMPLETE ALL SECTIONS Please print 1. Home Social Security No. City State Zip of Birth 2. Father/Guardian Mother/Guardian Social Security No. Social Security No.. Employer Employer Please indicate another person that is likely to know where you can be contacted: Name Relationship Telephone ( ) If you plan to be away from home the week your son/daughter is in camp, please indicate times and procedure that you may be contacted. FEES FOR MEDICAL TREATMENT INCURRED BY YOUR SON/DAUGHTER WHILE AT CAMP WILL BE THE RESPONSIBLE OF THE PARENT/GUARDIAN. AN INSURANCE POLICY WILL NOT BE INCLUDED IN THE CAMP FEES. IF YOUR SON/ DAUGHTER SHOULD REQUIRE MEDICAL TREATMENT WHILE AT CAMP, AND YOU WISH THE COST FOR TREATMENT TO BE COVERED UNDER YOUR MEDICAL INSURANCE PLAN, PLEASE PROVIDE THE FOLLOWING INFORMATION. 3. Basic Medical Major Medical Company or Plan Company or Plan Policy Number Group Number Policy Number Group Number Please complete the information on reverse side of this form
Is the athlete on any medication of any kind? q Yes q No If YES, please list medication(s), reason for taking, and any special instructions Drug Allergies or Sensitivities Other Allergies Does the athlete require special medical needs? q Yes q No If YES, please explain: Please read BOTH statements below and sign the ONE of your choice! DO NOT SIGN MORE THAN ONE! Both parents/guardian should sign one of the following sections. If one of the parents is unavailable, the signature of the available parent is sufficient. However, if the parents are divorced, only the parent having custody of the athlete should sign. If the athlete has a legal guardian(s), the guardian(s) should sign. 1. If my son/daughter needs medical attention while at summer sports camp at Clarion University, it is my wish that I be contacted before any medical procedures are performed, unless immediate emergency treatment is necessary to save my son/daughter s life, or to prevent permanent debilitating injury. Parent(s)/Guardian(s) / / 2. If my son/daughter needs medical attention while at summer sports camp at Clarion University, it is my wish that the treatment be begun while efforts are being made to contact me. So that treatment will not be delayed, I consent to any medical procedures that the attending physician believes to be appropriate, with the understanding that efforts will continue to be made to contact me. I also accept responsibility for all costs related to such treatment. *Exceptions. If there are any medical procedures that you do not want performed until you are contacted, please list them in the space provided. Otherwise, write none. Parent(s)/Guardian(s) / / If the athlete is 18 years of age, he/she must also sign this agreement / /