• u18 Netforce
• u17 ECNL Explosion
• u17 Courage 92
• u16 ECNL Cardinals
• u15 ECNL HotSpur
• u15 Courage 94
• u14 ECNL Jorden
• u13 ECNL Harkes
• u12 ECNL Independence
• u12 Rockets 97
• u12 FCV 97 Boys
• u11 Hotspurs 98
• u10 Pride 99
• u10 Elite
• u9 FCV Boys

TERRY FOLEY ACADEMY JULY 2009 CAMPS

The Terry Foley Academy Summer Soccer Camps teach an understanding of soccer skills and tactics in a relaxed learning environment. Daily schedule will consist of technical training, small sided games and FUN
Where: Poplar Tree
When: July 6 – July 10, 2009 Time: 8:30am - 12:30pm
Or July 13 –July 17, 2009 Time: 8:30 -12:30 pm
Cost: $ 175.00 session Ages: 7 yrs – 16 yrs.

What to Bring:
soccer ball, shin guards, soccer cleats,
water bottle and lunch w/ drink

Directions to Poplar Tree: 4718 Stringfellow Rd, Chantilly
From 66- Take Exit 55 onto Fairfax County Parkway. Head North towards Reston/Herndon. Turn Left onto Fair Lakes Pkwy. Turn Right onto Stringfellow Rd. Turn Left onto Poplar Tree Park. 

Registration Deadline: June 30, 2009. Mail completed registration form, medical form and check payable to: The Terry Foley Academy
FCVirginia
P.O. Box 129
43053 Pemberton Square Suite 120
South Riding, VA 20152
Questions: Please contact Lynne McMillan: lsmcmillan@cox.net

MEDICAL RELEASE FORM

TERRY FOLEY ACADEMY
CAMP DATES 2009

JULY 6 – July 10, 2009 
July 13 – July 17, 2009 
Boys and Girls Ages 7 - 16

REGISTRATION and Medical Information
All REQUESTED INFORMATION MUST BE PROVIDED AND SIGNED.

Camper Name__________________________________________________

Address: _______________________________________________________

City__________________________________________________________

Age______________ Date of Birth ___________________

Phone Contact __________________________________________________

COST: $175.00/Week

HOURS: 8:30 am – 12:30 pm


July Camps Registration Deadline is June 30, 2009. 

Mail completed registration form, medical form and
Check for $175.00 payable to Terry Foley Academy to: 

FCVirginia
P.O. Box 129
43053 Pemberton Square Suite 120
South Riding, VA 20152
Questions: Email Lynne McMillan – lsmcmillan@cox.net 

Terry Foley Academy and FCVirginia are not responsible for
any lost or stolen property


Mother’s Name________________________________________________________
Cell Phone_____________________________________________________________
Father’s Name__________________________________________________________
Cell Phone_____________________________________________________________
If Parents/Guardian cannot be reached, call
___________________________________ Phone _____________________________

Family Physician __________________________________
Phone Number____________________________________

Please attach and explain any serious medical conditions and list the names of any medications the camper is presently taking and for what medical conditions.

Allergic to Penicillin Aspirin Other ______________________________________
Insurance Company and Policy Number____________________________________
__________________________has been examined within the last 12 months and no medical reason has been found that he/she cannot participate in this camp. His/Her records show that all immunizations are up to date.

I agree that in case of an accident involving my child while attending camp and with full awareness that soccer is an activity that may involve risk or injury, I release Terry Foley Academy and FCVirginia from any and all liability. In case of an emergency, I give permission to have my child properly transported to a medical facility for care. I understand that Terry Foley Academy and FCVirginia do not provide medical insurance and that I will be responsible for all medical expenses incurred. Terry Foley Academy has established the following procedure for injury or sickness: (1) the camp will call home, (2) call the father's, mother's, or guardian's place of employment, (3) call the emergency numbers and physician, (4) call an ambulance if necessary for transportation to medical facility, (5) attending physician will make judgment on admittance, (6) Terry Foley Academy will continue to call parents, guardian or physician until one is reached. If I cannot be reached and the camp has followed the above procedures, I assume all expense for transportation and medical treatment. I also hereby consent to any treatment, surgery, diagnostic procedure, or the administration of anesthesia which may be carried out based on the medical judgment of the attending physician.


By signing below, I agree to all the terms detailed above

Parent/Guardian Signature Date


______________________________________________