REGISTRATION AND WAIVER FORM
2017 Locations:
Name: _____________________________
Northeastern High School Team Camp:
June 123-15, 6:00 p.m.-9:00 p.m., Mon.-Thurs.
Northeastern High School Practice Fields
Address: ___________________________
___________________________________
City
State
Zip
Northmont High School Team Camp:
June 19-22, 6:00 p.m.-9:00 p.m., Mon.-Thurs.
Northmont High School Practice Fields.
Telephone: __________________________
Age: _________ Grade Next Fall ________
Botkins/Indian Lake: June 26-30, 6:00 p.m.-9:00 p.m.,
Mon.-Thur. Botkins High School Practice Fields
Xenia: Open registration, ages 5(X Academy welcome)14. July 10-July 13, 6:00pm-9:00pm, Mon.-Thur. Club
X Fields
Wilmington: Open registration - ages 5 & up and High
School, July 17-20, 6:00 p.m.-9:00 p.m., Mon-Thur.
Robert Hensley Fields-David Williams Park.
Fairfield Leesburg: Open registration – ages 5 & Up
and High School, July 24-27, 6:oo p.m.-9 p.m. Fairfield
High School Practice Fields.
.
Spirk Motto:
“Never Give Up”
STEVE SPIRK
Women’s Head Coach at Wilmington College,
25th year, 294-146-37 record, 1994, 1996
NSCAA Regional Coach of the Year, 4 time
Ohio Coach of the Year, holds NSCAA National
License, Ohio Div. III Coach of the Year 2003.
His teams competed in the 1994, 1996, 1997,
2000, 2002, and 2003 (sweet sixteen) NCAA
Division III National Tournaments, and were
Ohio Athletic Conference Champions in 2000,
2001, 2002, and 2003.
Jacob Morrison, Asst. Coach Wilmington
College will be assisting Coach Spirk. Coach
Morrison played soccer at Ohio Christian
University and has his NSCAA Advanced
Coaching License.
Coach Spirk will also be assisted by top area
high school, college, club coaches and
Wilmington College soccer players.
Check us out on FACEBOOK:
SPIRK SOCCER SCHOOL
Check T-shirt size.
Birth date_________
Youth: M____ L ____
Adult: S ____ M____ L ____XL____
Emergency Phone: ____________________
Make check payable to Steve Spirk
Full payment must accompany the
registration and waiver form. Send to:
Steve Spirk
453 S. South St.
Wilmington, OH 45177
SOCCER RELEASE & WAIVER
In consideration of my child’s application being
accepted, I, intending to be legally bound, do hereby,
for myself, my heirs, executors and administrators,
waive, release, and forever discharge any and all
rights and claims for damages sustained by the
participating child, arising from or out of said
participation.
Email: ____________________________
Parent’s Signature: ___________________
PLEASE CHECK DESIRED CAMP:
Northeastern _____
Botkins _____
Wilmington _____
Fairfield _____
Xenia _____
Northmont _____
CAMP PHILOSOPHY
&
TEAM TRAINING
The coaching staff is highly skilled in the
technical instruction for improving ball
control, one on one attacking and defending,
shooting, tackling, and passing. Instruction
with small sided game training will enable
players to work on newly acquired skills and
assist them in making correct tactical
decisions. We will also assist players in how
to develop a positive and confident mindset.
TEAM TRAINING: The coaching staff will
also train the team in group and team tactics
using 4 a-side – 6 a-side match related games
(World Cup) emphasizing attacking play.
WHAT TO BRING: Soccer cleats, soccer
ball, water, and shin guards.
COST: $75 Included in this price is camp Tshirt and Sling Pack (new). Cost for additional
family members is $65. Soccer balls may be
purchased for $25.
QUESTIONS: Call the Wilmington College
Women’s Soccer office at 1-800-753-0917 or
937-382-6661, ext. 262. If no one is in, please
leave a message.
DEADLINE: Mail back application and
registration fee early to reserve your spot.