1. Edinboro University Soccer Camp
Medical & Insurance Information
Men’s and Women’s
High School
Team Camp
The hospital requests that we have insurance informa-
tion available as well as your name and phone number.
In the event you are not available for parental consent,
The hospital medical staff may proceed with medical
treatment.
INSURANCE COMPANY
___________________________________________
POLICY NUMBER
Please indicate any medical concerns we should
be aware of:
Read and sign the following release:
We, the undersigned parent(s) and or legal guardian(s)
of a camp participant under the age of 21 years, do
hereby agree that he or she may participate in the
Edinboro University Soccer Camp.
In consideration that he or she has been accepted by the
Edinboro University Camp for instructions we do fur-
ther agree for and on behalf of him or her and for ours-
elves individually that we will assume all risks associated
with any portion of the camp including traveling to and
participating in activities while on campus. In coopera-
tion with such course of instruction we will bind Edin-
boro University and the enacting staff harmless against
all claims for damage to person or property while trave-
ling or participating in this activity on campus.
SIGNATURE OF PARENT/GUARDIAN
____________________________DATE:__________
July , 2017
7/19 – Check In – 12:30 pm
7/22 – Check Out – 11:00 am
Edinboro University
Of Pennsylvania
Sample Daily Schedule
7:30-8:30
9:00-11:45
12:00-1:45
2:00-4:45
4:45-6:00
6:30-8:15
9:00-10:30
10:30
Breakfast
Team Training
Lunch
Dinner
Scheduled Games
Match Day Analysis
Lights Out
Men’s and Women’s
High School
Team Camp
**Bring swimsuits for swimming facilities**
July , 2017
3 Games Guaranteed
Team Evaluation at the End of Camp
“Technical, Tactical,
and Mental Total
Player Development”
All teams will have certified USSF
or NSCAA coaches. Every day will
end with match analysis with the
respective coach.

2. Edinboro Soccer Camp Application
Camp Staff
Camp Philosophy
Registration
The Edinboro Soccer Camp is designed to make you a
better player. You will be schooled in ways to not only
train with your team, but also in ways to train on your
own. Our staff of international and collegiate coaches
offer you intense individual technical training.
The skills you will learn at each training session can
immediately be put to use in the small-sided games. You
are encouraged to try what you have learned.
As well as contributing to the local community, our goal
at Edinboro University is to offer quality personal instruc-
tions to youth players at an affordable price so every
player has the ability and facilities to improve their soccer
skills.
$330 per camper for Highlands Dorms
*A goalkeeping coach will be present to work
exclusively with the goalkeepers daily*
To reserve a place in residential camp,
send this application for each player and a
$500 team (non-refundable) deposit payable to:
Edinboro University Youth Soccer Camp
Mail to: P.O. Box 541, Fairview, PA 16415
Gary Kagiavas
Head Women’s Coach – Edinboro University
Former Assistant Coach – Gannon University
Two-time PSAC Coach of the Year
Former Professional Player
USSF & South African Coaching Licenses
MSA Coaching Director
Erie Premier Sports Camp Director
Rene Lawrence
Head Women’s Coach – Lake Erie College
Youth Club Coach – Whitecaps Soccer Club
Bill Pfeiffer
PA West ODP Staff Coach
Head Women’s Coach – Moon Area High School
Youth Club Coach
Chet Gapzynski
Region 1 ODP Staff Coach
Director of Coaching – FC Pittsburgh
Jamie Sallie
Assistant Women’s Coach – Edinboro University
Youth Club Coach – MSA
Buddy Cooper
Assistant Women’s Coach – Lake Erie College
Youth Club Coach-Excalibur Soccer Club
Edinboro Soccer
Camp Application
Facilities
Team Name _____________________________
Name __________________________________
Address ________________________________
City _______________ State ___ Zip ________
Date of Birth _______________ Grade _______
Parent/Guardian __________________________
Cell Phone ______________________________
__________________________________
Edinboro University features recreational facilities such as
an AAU-size pool, basketball complete gymnasium,
racquetball, sand volleyball, bookstore, and convenient
store and bank.
Teams will stay in the new, state of the art Highlands dormitories. Rooms are 4 players per room and include
air-conditioning. Each player is responsible for bringing
their own sheets, towels, and toiletries.
The University is only 18 miles south of Erie and 100
miles from the cultural centers of Pittsburgh, Cleveland,
and Buffalo.
When traveling north or south on I-79, take the Edinboro
exit and follow RT. 6N to Edinboro.
Please check your choice
___ Field player ___ Goalkeeper
___ I am purchasing the camp ball
(Please enclose payment of $25 for the ball
with your application)
___ I will bring my own ball
For additional information, contact:
Gary Kagiavas
Please circle your t-shirt size
S M L XL