ࡱ>  @ 2bjbj {0 7$>"""","$>qK#(F#F#F#F#9,9,9,JJJJJJJ$UMROKj4*l9,j4j4KF#F#+K777j44F#F#J7j4J77RH,@JF## ö<"4IJAK0qKIPV5P<J0PJH9,-D7C/G0#9,9,9,KK>> "7>>"NAME OF APPLICANT (PLEASE PRINT) INSURANCE INFORMATION Coverage for accidental injury is required by all participants. In most instances, family health insurance is adequate. Please indicate your family health insurance plan below. HEALTH INSURANCE COMPANY: POLICY AUTHORIZATION NUMBER(S):  SHAPE \* MERGEFORMAT WAIVER AND RELEASE We, the undersigned, for ourselves, our heirs, executors and administrators, waiver and release and forever discharge, Darien High School, Future Star Sport Camps,LLC, its staff, officers, agents, representatives, employees, successors and assigns of and from any and all rights and claims for damages to personal property which may be sustained or occur during participation in camp activities, or from camp, whether paid damages, injury or loss are due to negligence or not. I certify that the applicant is in good physical condition to take part in the Girls Elite Volleyball Camp. Guardian Signature Date  boys & girls VOLLEYBALL CAMP    SHAPE \* MERGEFORMAT  CAMP PHILOSOPHY The camps goal is to stimulate the love of the sport of volleyball. The camp is dedicated to provide individual instruction to players of all ages and abilities. A low player to coach ratio and players to court ratio makes for a great teaching and learning environment, allowing coaches to share their passion for the game. Instruction will include the fundamental skills, tactics and techniques of power volleyball. THE DIRECTORS Jeff Brameier Founder of Elite Sports Camps. Director Future Star Sport Camps,LLC. Laurie LaRusso Head Coach Darien High School 18 FCIAC Championships 14 CIAC State Championships 10 time # 1 Team in Connecticut. CT High School Coach of the Year National HS Region 1 Coach of the Year Womens Sports Foundation Community Level Coach of the Year Junior Olympic Club Coach 15 years USA CAP Level III Coach INFORMATION For further information call: Jeff Brameier (H)762-3568 (W)655-3981 X2210 or JBrameier@darienps.org INSTRUCTION The members of the staff represent years of coaching and playing experience. All aspects of the game will be covered including: Passing Overhead passing/setting Spiking Digging Blocking Game Tactics and Strategies Setters will be provided extra instruction INSTRUCTORS/STAFF Individualized instruction by a knowledgeable coaching staff that represents years of coaching and playing experience. Campers are certain to leave camp with a greater understanding and enjoyment of the game of volleyball. SCHEDULE Players entering grade 9-12 8:00-8:30 Registration/check-in (Aug 17 ) 8:30-11:30 am Camp Session Players entering grades 9-12 3:30-4 Registration/check-in (Aug 17) 4-7pm Camp Session COST: $275.00 SPACE IS LIMITED NO REFUNDS MEDICAL TRREATMENT AUTHORIZATION I/We, being legal guardians of the applicant, authorize the Future Star Sport Camps,LLC and its agents permission to request medical treatment as necessary to insure the well being of our dependent. Guardian Signature Date FUTURE STAR SPORT CAMPS,LLC Jeff Brameier 37 Tanners Drive Wilton, CT 06897 Phone (203) 762-3568 2009 SUMMER CAMP MONDAY, AUGUST 17 FRIDAY, AUGUST 21 LOCATED AT DARIEN HIGH SCHOOL Two SESSIONS: PLAYERS ENTERING GRADES 9-12 8:30-11:30 AM PLAYERS ENTERING GRADES 9-12 4-7 PM -----------------------------------------------------------------------------------------DETACH AND RETURN------------------------------------------------------------------------------------------------ BOYS & GIRLS ELITE VOLLEYBALL CAMP REGISTRATION FORM PLEASE MAKE CHECKS PAYABLE TO: FUTURE STAR SPORT CAMPS RETURN TO: JEFF BRAMEIER, 37 TANNERS DRIVE, WILTON, CT 06897 NAME:____________________________________________________ DATE: ___/___/____ LAST FIRST ADDRESS:________________________________________________________________________ NUMBER & STREET CITY STATE ZIP HOME PHONE(____)___________AGE____BIRTHDATE___/___/___GRADE COMPLETED AS OF 7/1/09 _____ SCHOOL __________________POSITION______________E-MAIL ADDRESS _______________________ Session Choice:_Am________4pm_______ENCLOSED IS MY COMPLETED APPLICATION AND CHECK FOR $275.00 PLEASE COMPLETE REVERSE SIDE "9  % & ' > ? 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WAIVER AND RELEASEX@%AED@RLDD>E?1E- 2 . m +@Garamond-R2 ,/We, the undersigned, for ourselves, our heirs, B&%&&"&&&&%# &%&[2 ` ,5executors and administrators, waiver and release and "%&&&&:&&2$&&&&/2 ,forever discharge, Darie&#&'":42 n High School, Future Star (&9"&$ &&&*%%$"2 ( ,Sport Camps,LLC$&&0:&++02 ( =, itsT22 (  staff, officers, agents, & "&\2 ,6representatives, employees, successors and assigns of & &# :&& % &&&"&&\2 ,6and from any and all rights and claims for damages to &&&:&&&"&&&:&&:"&V2 T,2personal property which may be sustained or occur &&'&'&2& &:&&&&&&%^2 ,7during participation in camp activities, or from camp, &%&"&&'&&:&#&&: :&%2 ,whether paid dama,2&&&&&::2 Uges, injury or loss are due to "&%&'&%&z2 ,Jnegligence or not. &""&&&&U2 ,1I certify that the applicant is in good physical c&&&'&&"&'&&&[2 H,5condition to take part in the Girls Elite Volleyball ,&&&&&&#'&&:13& &2 ,Camp.T0:& 2  #&2 t,Guardian Signature:%&&$"&% 2 t_ % 2 t , 2 t ,2 tDate: 2 ti "@Garamond- 2 ;, ) 2 {  ) 2 F  ) 2   ) 2   ) 2   ) 2 s  ) 2 >  ) 2   ) 2   ) 2   ) 2 j  ) 2 5  ) 2   ) 2  ) 2  )@"Arial Black- 2 e  @- 2  + 2   +@"Arial- 2   (Y@Garamond- 2 BOYS & GIRLSmi&Q%%v=pf&Q 2  U- @ !H,0- 'j@Garamond-"2 VOLLEYBALL CAMP\s[[f^a^[[!b^X 2  M- @ !Hr0- ' @Wingdings- jv<,xA @.w<(@    &&&;;;666777444222555111$$$333000...<<<///888---999:::***???)))EEE+++%%%,,,===@@@>>>(((BBBFFF"""PPPAAA '''IIIMMMDDDGGGCCCHHH###!!!RRRJJJNNN       F                   P   P      "     "     9.).-0A7,2  4 %  P120=,78?6)20+?-08      .B29:9()+:):=1-980-,     +-ED86*1;(+A1.7).+96.-+   P[8007HA,+,)-+1.--:0-*+*,,-)   01..3;91::2)6)1),1B2+7+:.-,+*)    %000+++---++++0+0+++000+++++,.-,*  -0',,00+---+0+0000000000+000+.6+.)  )),H[000,00000,,0,0000000+00+00160.)  2E)'[(=0,00,,00,,,,,,,0,000000000.1+.) 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F   79.A)7A:60+0+++++*178,-             8:<-8(?7+++++++++.77(LW.         10:;A3)+0+0000+)*,A0-LAA0     V     PAE61E'0+0000006)76.B2T)21+   F   U S 16+9,0000000+.-)7.2@.2-D6H   N     EQ.00000000:61.)8>.,E8R38+,:J8.-<.+    A1-026-B,,0+++0++-++++++22,0+97H1-E*,;+ F   CA9)6??,000+0+0000,0000<0.D812E++A?7:)F G  @776,,0000+0,,,,,,000AB6-+*86*.+02)     /<,17.2*?*++,11.00-0..,,..0+.6+1-       &/3@'>A1(6,0++--,1.+-))-++00.1+.)      *=>?,,*0610+++,---.61,0+.1+1-        "<607-+7:).27*-+,0-)++.1+.)      -2;8,+*3.16.+-01+-,1+1-   4     567+28**9::7.2-),.+1)     /(.00121)3-)0.-.)       '()*+,-.*      &" %   " % %  "# $   !                      ''' 2 j  - 2 o< )'--% 1 -- '-- $/~/ \ \~-- 'h 1\@Garamond-C2 o%\1h MEDICAL TRREATMENT AUTHORIZATION =/4-,+-///+.=/9.,3-:5.-+.48@Garamond-2 Uo \1h I/We, being ";""=2 U!\1h legal guardians of the applicant, !"""!"""2 U \1h authorize !"":2 o\1h the Future Star Sport Camps,LLC"& ! ""+4"&&+%2 \1h and its agents e!""_2  o8\1h permission to request medical treatment as necessary to "4"""!!4"4!""F2 o'\1h insure the well being of our dependent."!"-""!"!""!"! 2 c\1h -&2 I o\1h Guardian Signature4!"" "! 2 I c\1h d 2 I \1h , 2 I \1h ,2 I \1h Date4- 2 I \1h # 2  o\1h $'--%[ C -- '- -$aDDaa-- '@{@Garamond- 2 @2009>?>>2  @ SUMMER CAMP!Eez{^]![WzR- 2 @ 7 2 @M\%2 ]@ONDAY, AUGUST 17 eOTNBBBLIL3E'/ 2 (@22 Z@ %2 @ P@FRIDAY, AUGUST 21e=F(NBBBLIL3E.( 2 @ @ 5@Garamond-.2 @LOCATED AT DARIEN HIGH e:I><?AH<?H<@$ANP$CP2 t i@SCHOOL/>PHI: 2 t @ 1@Garamond-2 F @TwoEG4 2 F x@ 2 F  @ SESSIONS:3G33(OT3 2 F @ 6@Garamond-12  z@PLAYERS ENTERING GRADES 93576;:*;G9;:!F==;6A;*' 2  |@-2  @12!' 2  @  2  @ .-2 @8:30/// 2 @-!2 @11((2 "@:30//2 @ AMA\ 2 P@ 5- 2 -@ -12 wz@PLAYERS ENTERING GRADES 93576;:*;G9;:!F==;6A;*' 2 w|@-2 w@12!' 2 w@ .- 2 G|@  2 G@  2 G@4/ 2 G@-!2 G@7 PM/=\ 2 G@ 6 2 -@ 6 2 -@ 6'--%,,-- '--%,hYh-- '--%,0Y0-- '--%??-- '--%*X vX -- '--%*v-- '- -$ , BB, ,-- '77E  @"Arial Black- 2 J6 E 77FUTURE STAR2?6?:666::2 6E 77 SPORT66?:62 6E 77 CAMPT;:G62 6E 77S,LLCT622: 2 6E 77 A @"Arial-2 J E 77Jeff Brameie&*2*?)* 2  E 77r 2  E 77 '#2 Je E 7737 Tanners Drive**.*)**&6%* 2 e E 77 '#2 J E 77Wilton, CT 06897G)*6.)**)* 2  E 77 ' @Garamond-"2 J E 77Phone (203) 762*&&&#####$ 2 * E 77-2 A E 773568##$# @Garamond- 2  E 77 *'-                     ՜.+,D՜.+,4 hp|     Brochure Title0lt|UseDefaultLanguageVersionLCID hM7w   !"#$%&'()*+,-./123456789:;<=>?@ABCDEFGHIJKLMNOPQRSTUVWXZ[\]^_`abcdefghijklmnopqrstuvwxyz{|}~Root Entry F<Data 6-1Table0PWordDocument{0SummaryInformation(Y$DocumentSummaryInformation8CompObjj  FMicrosoft Word Document MSWordDocWord.Document.89q