Direct Kick Field Player Academy
Kennett Middle School, Conway, NH
August 9^th – 12^th
Directed By- Giovanni Pacini
Mt. Washington Valley Soccer Club Technical Director

Direct Kick Field Player Academy has arrived in the Mt. Washington Valley! Directed by Giovanni Pacini, a noted expert in the area of player development with international experience brings his unmatched expertise to the Valley. As an NSCAA Master Coach and credentials that include working with some of the finest coaches in the world, players who attend Direct Kick will be exposed to the very latest techniques in training players.

Session I- Ages 8 to 12 / 9 AM – 12 PM

Every player who registers gets a free Direct Kick t-shirt!

Direct Kick Field Player Academy is endorsed by the Mt. Washington Valley Soccer Club.

2010 DIRECT KICK FIELD PLAYER ACADEMY REGISTRATION AT KENNETT MIDDLE SCHOOL  

·         Complete a registration for each participant attending.
·         Include a physician’s proof of immunization and medical clearance for each registrant.
·         COST: $79.00 (Must be paid in full with each application).
·        Session I- Ages 8-12 / Session II- Ages 13-17 

CHECK WHICH SESSION YOU WILL BE ATTENDING:

______  Session I (9 AM – 12 PM) ______  Session II (2 PM – 5 PM)

Player Name _________________________________  Address _________________________________________

City / Town ____________________________  State _________  Zip ________   Age _______ Grade ______

Home Phone (            ) ___________________________ Work Phone (            ) __________________________

Cell Phone (            ) ___________________________ E-Mail ________________________________

Parents Names ____________________________________________________________

Please check t-shirt size:  ________  Small   ________  Medium    ________ Large   ________ X-Large

 Tuition to Direct Kick Field Player Academy is $99.00 per session and must be paid in full
with this application. Application deadline is July 1^st, 2010. Enclose with your application proof of immunization and
medical clearance for each registrant. Families sending more than one child may take a $10.00 discount for each additional child.

This cannot be used with any other promotion. Tuition is non-refundable.  Make check payable to Giovanni Pacini and send it with your application to: Giovanni Pacini, 39 Pilgrim Road,  Braintree, MA  02184.

The undersigned realizes that there are risks associated with the physical activity within this camp environment.
The undersigned agrees not to hold Direct Kick Field Player Academy, its director, staff, sponsors, and anyone associated with
Direct Kick liable in the event of injury to the participant noted on this application. In addition, the undersigned agrees to
fully compensate Direct Kick for any damage incurred by the registered participant on this application.

___________________________________                                             _____________

Signature of Parent or Guardian                                                                         Date