2010 Mansfield University Elite Soccer Academy

Online Registration Form (Below)

Mansfield ELITE Soccer Academy

Winter Indoor Soccer Programs

 Kids (Male & Female) Age 5-12

The Mansfield University Women’s Soccer Team will once again offer Indoor Soccer Programs this winter. The programs will be held at Kelchner Fitness Center on the campus of Mansfield University. All of the programs will include instruction followed by indoor soccer games.  You have the option of a two week or three week program for ages 5-12.  Or you can sign up for both!!! Fill in the form below and mail back to Tim Dempsey with payment at the address given or you can register on-line by going to the following website: www.GoMounties.com then click on indoor soccer registration icon on the left side of the page . Payment for on-line registrations will occur the first day of the program. Questions, contact Tim Dempsey at tdempsey@mansfield.edu or call 662-4454.

INTRODUCTION LEVEL                                                                                    INTERMEDIATE LEVEL

Age Group:                            5, 6  year old boys and girls                                    Age Group:                            7, 8, 9 year old boys and girls

Dates of Program:                 Three Week (Sat., Jan 23 & 30, & Feb. 6)              Dates of Program:                Three Week (Sat., Jan 23 & 30, & Feb. 6)

                                                Two Week (Sat., Feb 13, & 20)                                                                               Two Week (Sat., Feb 13, & 20)         

Time of Program:                  9:00 am-10:30 am                                                   Time of Program:                 9:00 am-10:30 am

Location of Program:           The Kelchner Fitness Center                                   Location of Program:           The Kelchner Fitness Center

Cost of Program:                  $25/child for the 2 week program                            Cost of Program:                   $25/child for the 2 week program

                                                $35/child for the 3 week program                                                                            $35/child for the 3 week program

                                **$50/child if you sign up for both programs                                         **$50/child if you sign up for both programs

ADVANCED LEVEL         

Age Group:                            10, 11, 12 year old boys and girls          

Dates of Program:                 Three Week (Sat., Jan 23 & 30, & Feb. 6)

                Two Week (Sat., Feb 13, & 20)            

Time/Location of Program:  11:00am-12:30 pm   

Location of Program:           The Kelchner Fitness Center

Cost of Program:                  $25/child for the 2 week program

                                $35/child for the 3 week program

**50/child if you sign up for both programs          

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Registration Form for Indoor Programs

Program # 1: ___ Three Week Program           Program # 2____Two Week Program             Program # 3____ All 5 weeks

                              (Sat. Jan. 23, 30, Feb. 6)                                     (Sat. Feb 13 & 20)                                              Cost:$50/child

                               Cost: $35/child                                                    Cost: $25/child

 *** To ensure a quality program, registration will be limited to the first 25 participants that sign up in the various age groups***

Participants Name:__________________________________                                              Age:__________

Address:__________________________________________                                              Gender: _______

                ___________________________________________

Email: ____________________________________________

Return Completed Form and Payment to:                Tim Dempsey

    (make checks payable to: MU Soccer)                  Mansfield University

                                                                                    Decker Gym

                                                                                    Mansfield, PA   16933

NOTE:
-This form is NOT an official university application and does not include payment. This form will simply notify Coach Dempsey of your intent to enroll in the clinic. You must send payment through the mail, or pay the morning of the clinic.

-Please send payment to Tim Dempsey at the address above. (Checks payable to MU Soccer)