 Niagara University
Purple Eagles Youth Academy Training
Ages: U6-U13 Boys and Girls Dates: September 18 - November 6 (8 Sessions on Monday) Time: 5:30 - Dark ( Players need to arrive 15min early/5:15pm)
Location: NU Grass Field to the left behind the Kiernan Center (5795 Lewiston Rd Niagara, NY 14109) Cost: $200 per player Last session November 6 on turf 7-8:30pm
*The Niagara University Youth Academy is geared towards the soccer junkie who loves to play all the time, wants to challenge themselves and continue to develop. Players will focus on developing their technical abilities that consist of the following topics - dribbling, receiving, passing, finishing, goal keeping, and always finishing with a small sided game. Please email Michael Meyer if you have additional questions mmeyer@niagara.edu
|
 INFO: | Please note that this form contains limited capacity items which are sold out. They are displayed grayed out and/or are not selectable. |
Registration inquiries:
Michael Meyer
Assistant Men's Soccer Coach
mmeyer@niagara.edu
o: 716-286-8661
c: 513-258-5621
Michael Meyer
Assistant Men's Soccer Coach
mmeyer@niagara.edu
o: 716-286-8661
c: 513-258-5621
| = required field |
Oops! You do not have javascript enabled. This registration process depends on javascript to function correctly.
Please enable javascript in your browser and then reload this page.
 |
Registrant |  |
use this registrant for billing information
Camper Information
Additional Training Session ($25 for the week)
Early Drop Off / Late Pick Up ($25 for the week)
Early Drop Off / Late Pick Up ($25 for the week)
Male
Female
Female
Yes
No
No
General Medical Information
PARTICIPANTS with the following conditions must provide written physician's clearance before attending a Niagara Summer Soccer Camp. Please email (mrodrigues@niagara.edu) or bring with you to the first day of camp, an official letter of physician's clearance (for each item). Participants without official physician clearance will be withheld from competition until clearance is received in writing.
Yes
No
No
Yes
No
No
Yes
No
No
Yes
No
No
Yes
No
No
Yes
No
No
Yes
No
No
Yes
No
No
Yes
No
No
Immunization Information
PARENT/GUARDIAN AUTHORIZATION and NOTIFICATION
Meningococcal Meningitis is a bacterial illness affecting the brain. It can be spread by a cough, sneeze, kiss, sharing drinks, or by any other direct contact or airborne means of transportation. Therefore. student/campers residing in small areas, such as dormitories, are at an increased risk for contracting the illness.
The signs and symptoms of Meningococcal Meningitis are similar to the common flu often making it hard to detect. The signs and symptoms include the following: high fever, nausea, vomiting, fatigue, headache, stiff neck/back, skin rashes, and confusion. Frequently, not all signs and symptoms occur, and the illness may progress rapidly. Treatment of Meningococcal Meningitis is antibiotic therapy.
A vaccination is available, and is an effective way to help prevent Meningococcal Meningitis, although any vaccine is not an absolute guarantee. there are rarely side effects associated with this vaccination. Niagara University summer camps will not provide the Meningitis vaccine. Contact your family care provider for information regarding availability and associated costs of the vaccination.
I, the parents or legal guardian have received, reviewed, and understand the above information regarding Meningococcal Meningitis and my son/daughter has either received the immunization within the past 10 years preceding or has elected not to obtain the immunization against Meningococcal Meningitis.
To the best of my knowledge this health history information is correct and the person herein described has my permission to engage in all camp activities, with the exception of any physical limitations as described. In the event that I cannot be reach in an emergency, I hereby give permission to the medical personnel to hospitalize, secure proper treatment for, and to order injection, anesthesia, or surgery for my child as named above. I agree to indemnify Niagara University and its employees for any claim which may hereafter be presented by our (my) son/daughter as a result of any such injuries.
Check this box to indicate that you have read and agree to all of the above terms & conditionsMeningococcal Meningitis is a bacterial illness affecting the brain. It can be spread by a cough, sneeze, kiss, sharing drinks, or by any other direct contact or airborne means of transportation. Therefore. student/campers residing in small areas, such as dormitories, are at an increased risk for contracting the illness.
The signs and symptoms of Meningococcal Meningitis are similar to the common flu often making it hard to detect. The signs and symptoms include the following: high fever, nausea, vomiting, fatigue, headache, stiff neck/back, skin rashes, and confusion. Frequently, not all signs and symptoms occur, and the illness may progress rapidly. Treatment of Meningococcal Meningitis is antibiotic therapy.
A vaccination is available, and is an effective way to help prevent Meningococcal Meningitis, although any vaccine is not an absolute guarantee. there are rarely side effects associated with this vaccination. Niagara University summer camps will not provide the Meningitis vaccine. Contact your family care provider for information regarding availability and associated costs of the vaccination.
I, the parents or legal guardian have received, reviewed, and understand the above information regarding Meningococcal Meningitis and my son/daughter has either received the immunization within the past 10 years preceding or has elected not to obtain the immunization against Meningococcal Meningitis.
To the best of my knowledge this health history information is correct and the person herein described has my permission to engage in all camp activities, with the exception of any physical limitations as described. In the event that I cannot be reach in an emergency, I hereby give permission to the medical personnel to hospitalize, secure proper treatment for, and to order injection, anesthesia, or surgery for my child as named above. I agree to indemnify Niagara University and its employees for any claim which may hereafter be presented by our (my) son/daughter as a result of any such injuries.
Do you wish to update your member profile?
