JSC Soccer Camp
P.O. Box 34837
Juneau, Alaska 99803
2017 Soccer Camps
“Wee” Soccer Camps
July 10-14
Boys and Girls ages 5-7 yrs. old
$85.00
Choose the location that is most convenient
Valley
Downtown
9:00 a.m. – 12:00pm
1:00 p.m. – 4:00 p.m.
Adair Kennedy Turf Field
JDHS Turf Field
Soccer Camp
July 17-21
9:00 a.m. – 1:00 p.m.
11:00 a.m. – 3:00 p.m.
Boys and Girl ages 7-8
Boys and Girls ages 9-13
Adair Kennedy Turf Field
Adair Kennedy Turf Field
$110
$110
NEW – Register Online: http://www.juneau.org/parkrec/youth/tmountain.php
Ifthesplitschedulecausesconcernoraninconvenienceforyourfamily,wecanaccommodateyourrequests.
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2017JSCSoccerCamp–CampApplication
Waiver and Consent
Participant’s First Name: ____________________ Last Name: __________________________
Age: ________ Birthdate: ____________ Male or Female (circle one)
Address: _____________________________________________________________________
City: _______________________ State: ____ Zip: ____________
Parents Name: _________________________________________________________________
Home Phone: ____________________________ Work Phone: __________________________
Cell: ___________________________________ T-Shirt Size: Youth ______ or Adult _____
E-mail: _________________________________
Please indicate S, M, L or XL
Emergency Contact (If parents can’t be reached)
I recognize that participation in these camps involves a
risk of injury and in consideration of your accepting
this registration; I waive and release any and all rights
and claims for damage I may have against JSC Soccer
Camp staff and agents, and the City and Borough of
Juneau for any and all injuries suffered by me while
participating in this activity.
I, the undersigned parent/guardian of this applicant, a
minor, do hereby authorize the camp directors and/or
instructors as Agents for the undersigned to consent to
Medical, Surgical or Dental Examination, Treatments,
etc.
Parent/Guardian Signature
Name: _______________________________________________________________________
Relationship: ____________________________ Phone: _______________________________
More registration and payment information located on the other side
____________________________________________
Medical/Special Considerations
____________________________________________
JSC Soccer Camp 2017
Purpose
Our camp emphasizes individual skills, basic fundamentals and techniques, team play, and overall
well-being in a positive teaching and learning environment. Our approach to coaching and instruction
focuses primarily on teamwork, sportsmanship, leadership, self-confidence and improvement. Effort
over results will be emphasized.
The camp is also about a lot more than just improving your game! Every camper has the opportunity
to meet new friends in a positive environment where success is measured by effort and teamwork
and not by winning and losing. While the JSC camp strives to challenge each and every person, we
want to preserve the enjoyment of attending camp during the summer. Our goals are to teach and
instruct, but also and more importantly, to provide a fun and exciting soccer atmosphere at camp.
Camp Staff
Instructors at the JSC Soccer Camp will include Camp Director Matt Dusenberry, current Juneau
Soccer Club age group coaches, current high school players, as well as Juneau collegiate players.
Attendance at a JSC Soccer Camp includes:
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Professional Instruction
One Soccer Ball
One Camp T-Shirt
World Cup Team Competition
What to Bring:
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Your own training equipment (rain coat and sweats recommended). Please label all clothing.
Outdoor and indoor shoes
Lunch/Snack for all camps
Water Bottle
Register Online: http://www.juneau.org/parkrec/youth/tmountain.phpor fill out the form below
--------------------------------------------------------------------------------------------------------------------------------------Registration & Information
Applications must be received by June 23 for the Wee Camps and by
June 30 for the Intermediate and Advanced Camps or a $10 late fee
will be assessed. There will be NO REFUNDS. Applications are
confirmed upon payment. No written confirmation will be mailed. Walkup registrations are accepted on a space available basis on the first day of
the camp at the camp location. Do not mail cash.
Please mail forms and fees to:
Juneau Parks and Recreation Department
155 S. Seward Street
Juneau, AK 99801
If you are paying by credit card, registration forms may
be faxed to Parks and Recreation at 586-4589.
For more information contact
Juneau Parks and Recreation Department – 586 – 5226
Camp Director Matt Dusenberry (907) 957 -2087
Check Camp(s) for which you are attending:
o
o
o
o
Wee Camp – July 10-14 (9am-12pm, AKTF, $85)
Wee Camp – July 10-14 (1pm-4pm, JDHS Turf, $85)
Soccer Camp – July 17-21 (9am-1pm, AKTF, $110)
Soccer Camp – July 17-21 (11am-3pm, AKTF, $110)
o Full Payment Enclosed
Amount: _______________
Please make checks payable to:
Juneau Parks and Recreation Department
Charge my: ☐Visa
☐MasterCard
Card # _______________________
Amount:_________
Exp. Date: _______
Security Code: ____
Signature: ________________________________________
JDHS Turf located downtown – AKTF located in the valley near Floyd Dryden