2 Day High Performance Skills Clinic for Ages 10 - 18 years

Sunday 18th & Monday 19th December 2016

Monarch High Performance Academy in conjunction with GAP Resource Management and Fortitude Human Performance presents a unique opportunity for Junior Cricketers to receive Elite Level Coaching from Mark Higgs and Andrew Dawson during December to build on your 2016-17 Cricket Season.

Specialist Cricket Coaches & Tacticians

Mark Higgs and Andrew Dawson are High Performance Coaches, each bring 20 years’ experience both in a playing and a coaching capacity.

Mark has had coaching experience with the Prime Ministers XI and was a member of the National Spin panel. Mark has played for the Australian One Day Squad, Australia A, New South Wales, , in T20 Big Bash League 2 and ACT Comets as the .

High Performance Specialists Elite Training, Tactics & Strategies

Andrew was the Head Coach for Cricket ACT on the Cricket Australia panel and also coached the ACT Meteors for four seasons with the highlight of coming runners-up in the Cricket Australia Women’s National League T20 competition. Andrew is a Cricket NSW contracted specialist coach.

Together, Mark and Andrew have developed and managed a number of

Australian male first class players such as , Ryan

Carters, and and most recently with Australian female first class players such as and . MONARCH HIGH PERFORMANCE

ACADEMY Mark and Andrew were the former co-coaches of the ACT Comets program when they won the Cricket Australia Cup.

Mobile: 0410 628 001 Email: [email protected] Take your game to the next level

CLINIC REGISTRATION FORM Sunday 18th & Monday 19th December 2016 Berrambool Sports Centre & Grounds, Berrambool Drive, Merimbula 930am to 330pm daily

Proudly brought to you by GAP Resource Management & Fortitude High Performance

Inclusions & Player Details Specialist Coaches delivering High Performance Cricket Coaching throughout each day; Day One Registration at 9am with fruit and refreshment provided daily. Each participant will be required to bring their own full cricket kit (including helmet and all protective equipment) and wear appropriate cricket clothing. Each participate is responsible for their own lunch and snacks.

Player Name (Please complete a form per player) Player Address Parent/Guardian Email Address Parent/Guardian Contact Details Home Phone Mobile Phone Medicare Number & Position on Card Health Insurance Provider Insurer Membership Number

Do you have Ambulance Cover? (Please confirm) Age Band & Team/Division for 2016-17 season Cricket role (Batter, Bowler/type, Keeper) Highest Cricket Level achieved to date Name of Next of Kin/Emergency Contact Person Next of Kin/Emergency Contact Details Home Phone Mobile Phone

Payment Details & Consent Price is $200 per person for the 2 (two) days or $115 per person per day. I will transfer a total of $______for ______days (please list total number of days) into the below account:

Account Name Monarch High Performance Academy National Australia Bank BSB 082 968 Account Number Details 91 402 8982 Number of Days Attending (please tick to confirm) Day 1  Sunday 18th Dec Day 2  Monday 19th Dec

To be completed by Parent or Guardian and Player I/We (parent/guardian) of ______give staff/coaches of Monarch High Performance Academy permission to obtain Medical and/or Emergency Care as deemed necessary. I/we will be responsible for all costs incurred for medical and/or emergency care. Every reasonable effort will be made to contact the parent(s)/guardian(s) or the Next of Kin/Emergency Contact person using the contact details provided above.

Name:______Signed: ______(parent/guardian 1) Date: ______Name:______Signed: ______(parent/guardian 2) Date: ______Name:______Signed: ______(attending player) Date: ______

PLEASE EMAIL YOUR RESIGRATION AND CONFIRMATION OF ATTENDANCE TO: [email protected] In the event of inclement weather, Monarch High Performance Academy will make every effort to provide access to an appropriate alternate venue. If the clinic is cancelled due to extreme weather or other unforeseen circumstances, refunds will not be issued, however, a credit note equal to the value of the cancelled clinic (minus a $30 administration fee) will be provided for use at a future clinic or for one-on-one coaching sessions to the value of a one (1) hour session per cancelled day. This may be transferred to another child. Note, if your child is unable to attend the clinic (either partially or fully) due to illness, individual arrangements can be made, providing a valid medical certificate is supplied.