Player’s Name:
Parent’s Name:
Phone No:
Email Address (Please Print Clearly):
Club:
Age Group:
Date of Birth:
Clothing Size:
Medical Details
This forms needs to be completed by the Parent/Guardian of the child attending the
course
The form must be completed before the child takes part in the activities
Name
Age
Male/Female
Venue
Medical Condition
NONE
_____________________________________________________________________
Detail of Medication to be taken
_____________________________________________________________________
Emergency Contact and name
_____________________________________________________________________
Parent Guardian________________________
Date
____________________________
Thank you for completing this medical details form. This form must be attached to
the course register and given in to the regional manager of the course.
During the Program Coerver Leinster will record and Photograph some of our
academy’s, we will only use these images as part of our social media advertising.
It is essential that all children taking part in any of our sessions, roadshows or
camps wear shin guards, if they are not worn insurance for injuries while playing
will be null and void.
Children in the Coerver program are only insured by us during the specified
coaching times.
Due to our coaching schedule it is important that parents and guardians drop off
and pick up at appropriate times.
Please be respectful to all coaches and other children within the program. We
expect all our staff to be the same as they are role models to all involved, and this
helps create a safe fun environment for everyone to be part of.
All Coerver Leinster staff has all been trained in child protection and have been
fully Garda vetted. Our staff has also been trained to the age specific group that
they are teaching.
Please sign below to say you have read the above information.
______________________________
If you have any further questions or require any additional
information please contact us
Mobile: 083-171 8812
Email: [email protected]
www.coerverleinster.ie
TWITTER @CCLEINSTER
FACEBOOK @ COERVER COACHING LEINSTER
INSTAGRAM @ COERVER COACHING LEINSTER
Who are Coerver Coaching?
Coerver® Coaching is "The World's # 1 soccer skills teaching method" Inspired by the great
Dutch coach, Wiel Coerver & run by Co-Founders Alf Galustian & Charlie Cooke & Established
1984
Coerver® Coaching is endorsed and used by the world’s greatest managers, coaches, clubs and
federations & is an official partner of Adidas.
Coerver coaching is in Ireland both as a player development program and as a coach education
program.
Why Coerver Coaching?
Our Coerver coaching program is adaptable to every club and every league and is completely
flexible to your needs, your ‘players’ needs and your coach’s needs. Our programs are built
around the individual for whom they were developed for since 1984.
Coerver coaching is a global coaching method that focuses on technical player development
which is essential to tactical team development and implemented correctly both support each
other extremely well and is endorsed by federations from countries such as Spain ,Germany,
Holland & Japan to name a few and club teams such Real Madrid, Manchester United, Arsenal &
Bayern Munich. There are countless examples of playing the Coerver way but fundamentally it is
giving the player the confidence to be the best they can be technically so that they can play as
required tactically.
How the academy works:

46 weeks of Technical training a year ( 1 hour weekly sessions)

Full Adidas kit

Reduced rates at camps and clinics for both players and parents in the academy program

Once registered you can attend other performance academy’s free of charge (coach must
be notified)

Registration fee €55 ( Insurance & Kit) Monthly fee €39 (paid in advance every month)

First Skills fee €40 (Insurance& Kit) Monthly fee €25 (paid in advance every month)

Reduced rates for Families
For more information contact us on 083-1718812, [email protected] or through social
media on Facebook, Twitter or Instagram.