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Lacrosse Camps June 22–26,2009 June 15–18,2009 Lschs.Org/Laxcamp 215.402.4380 Qsilaxcamp Contacts Sponsored By: Or Girls Camp ® , Nike& Uslacrosse Ages 5-13

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Lacrosse Camps June 22–26,2009 June 15–18,2009 Lschs.Org/Laxcamp 215.402.4380 Qsilaxcamp Contacts Sponsored By: Or Girls Camp ® , Nike& Uslacrosse Ages 5-13 Authorization Last Summer at QSI Camp Advantages Medical Treatment The La Salle High School Camp Advantages: PAID The undersigned authorize and PRSRT STD PRSRT PERMIT #182 grant permission to the staff of Facility Advantages: US POSTAGE BENSALEM, PA QSI, US Lacrosse, and/or the • Over 4 full fields camp athletic trainer, to adminis- • Separate men’s and women’s camps ter needed first aid to my minor Over 300 • 3 gymnasiums for inclement weather child through a medical staff of Campers • Open cafeteria to purchase food their choice, customary med- • 2 indoor and outdoor pools for hot day relief ical/athletic training attention in 2008 • Air conditioned lecture hall room for college guest speakers and transportation, including • Entertaining video sessions in lecture hall medical treatment at a hospital in • Live DJ music case of emergency. I understand • Ease of paying online using Visa/Mastercard. every effort will be made by QSI Coaching Advantages: to contact me in the event of an Mr. Bill Leahy – Head Coach La Salle College High School emergency, and if I cannot be We expect another Freshmen Guidance Counselor Lacrosse Camps reached, I give my consent to physicians, paramedics and trainers to per- Coach Leahy is in his 18th year as Head Coach at La Salle College High form any necessary emergency treatment to my minor child. crowd so send School. He has achieved an overall record of 304 W - 58 L (216-3 in the L your registration Catholic League) which includes the 2004/2008 PA State Championship, 2005 ACROSSE ________________________________________________ in early! & 2007 State Finalist appearances, 2006 Final Four appearance, and 14 Mother’s/guardian’s signature Emergency phone number Philadelphia Catholic League Championships. He was recognized by the ________________________________________________ Philadelphia Inquirer as “Coach of the Year” in both 1997 and 2004. Bill is a Father’s/guardian’s signature Emergency phone number 1992 graduate of Loyola College in Maryland where he played and coached midfield and was considered a face-off specialist. From 1995-1996 he played __________________________________________________ forward for the Philadelphia Wings. Other emergency contact person Emergency phone number Mr. Tony Resch – Head Coach Philadelphia Barrage C __________________________________________________ Athletic Director, English Teacher Name of Child’s Physician Phone number Mr. Resch is the Athletic Director and Defensive Co-ordinator for La Salle AMP College High School and its Varsity Lacrosse team. His experience in the game __________________________________________________ of lacrosse is extensive as he was a player for Penn Charter High School and Allergies an All-American at Yale University. After college he went on to play for the Boys Camp Girls Camp F Asthma: ❏ Yes ❏ No Inhaler: ❏ Yes ❏ No United States World Team and to be the Head Coach at the William Penn Ages 5-16 Ages 5-13 Charter School and for Philadelphia's professional indoor team the Wings. OR __________________________________________________ Last summer Mr. Resch served as the Head Coach of the two time World ... Medications Champion (MLL) Philadelphia Barrage. He earned the 2006 /2008 MLL June 15–18, 2009 T “Coach of the Year” award along with his team championship. HE Insurance Information: Megan Fortunato – Women’s Camp Director UTURE June 22–26, 2009 Coverage for accidental injury is required for all camp participants. In most Coach Fortunato is in her 10th year as a Quickstick Lacrosse Camp Director. A F instances, family health insurance is adequate. You must complete the fol- graduate of the University of Delaware where she won women’s lacrosse hon- F HE lowing: ors as 1st team America East and 1st Team All Regional American. Currently UTURE she is coaching at Upper Moreland High School. T Contacts __________________________________________________ Health Insurance Company Ins. Co. Phone number (required) La Salle Lacrosse Advantages: Office: 215.233.2911 ext. 4380 • State Championships in 2004 & 2008 OR F __________________________________________________ • 2005 & 2007 State Championship Finalist –US Lacrosse Magazine 215.402.4380 Policy Number Group Number • 2006 Final Four Participant ... • State Rankings: 2004 #1, 2005 #2, 2006 #3 , 2007 #2, 2008 #1 www.qsilaxcamp.com __________________________________________________ AMP • National High School Ranking in 2004 (#13), 2005 (#21) , 2007 (#11), 2008 (#1) or C Policy Subscriber’s Name in the Nation! • 24 High School All-Americans www.lschs.org/laxcamp #1 High School Team Are you or your child a current member of US Lacrosse? If so, provide • 14 Philadelphia Catholic Championships since 1992 US Lacrosse Magazine your membership ID# for additional free insurance coverage _______ • 41 High School All-State Awards • 80 Collegiate Division I Scholarships Sponsored by: • 152 High School All-Catholics Awards Competitive Edge Outfitters, Wave One Sporting Goods, • 87% Overall winning percentage (304 W – 58 L) ACROSSE La Salle College High School, STX®, Nike & US Lacrosse L LaSalle College High School Camp, Inc. c/o Quickstick Intensive Lacrosse 8605 Cheltenham Avenue 19038 PA Wyndmoor, • 99% PCL winning percentage (216 W – 3 L) The Explorers (31-2) posted eye-opening numbers that were just to hard for us ignore. In addition winning more LaSalle games than any other team in the country this year, continued its domination of the Philadelphia Catholic League (PCL) by winning its fifth straight league crown and squad then 14th in the past 16 years. Coach Bill Leahy’s added both the Eastern Pennsylvania Scholastic Lacrosse Association (EPSLA) championship and the Keystone Cup state title to its 2008 resumé. The program has amassed a whopping 138 victories over the past five searsons. Camp Welcome Camp Locations Registration 2009 Registration Form Authorization Dear Lacrosse Camper: Day Camp Evening Camp By Mail TO BE COMPETED BY PARENT OR GUARDIAN. TYPE OR PRINT IN INK ONLY. Waiver and Release of Liability It is our pleasure to invite you to our annual co-ed La Salle Lacrosse Camp FILL IN ALL SECTIONS. This form may be copied for additional applications. La Salle High School S4 @ La Salle High School To enroll a camper a parent or guardian should complete all parts of the Season! Join us and an outstanding teaching staff for a week of fun, creative, You may also register for more than one La Salle summer camp. Your pay- The undersigned, individually and as parents and/or guardians of (insert child’s Dates: June 22-26, 2009 Dates: June 15-18, 2009 registration form and send it with full payment. name) _____________________________, a minor child, ask that and intensive lacrosse instruction. One-on-one training, challenging compe- ment, in full, must accompany this registration form. Time: 9:00 a.m.-2:30 p.m. Time: 5:00-8:30 p.m. he/she be admitted to participate in the sponsored activities of Quickstick Intensive titions, informative lectures, creative drills, high fidelity video sessions, and Ages: Boys 5-16 & Girls 5-13 Ages: Boys 11-16 Lacrosse Camp ("QSI") and that he/she will only participate in those US Lacrosse first-rate facilities all add up to a great lacrosse experience. Each instruction- competitions and activities sponsored by QSI . We verify that the child has been or Fee: $250 Fee: $200 By Internet 2009 Locations al period is tailored with one goal in mind – to make you a better lacrosse Visit www.qsilaxcamp.com or www.lschs.org/laxcamp and follow the secure Please check appropriate camp(s) you are attending this summer. will be examined by a licensed physician prior to coming to this camp, or we know- player. So, please join us this summer, and be a part of the annually sold-out registration and payment instructions. Registration online reserves you a ingly decide not to have the minor examined, and we state that the child is physi- Day Camps ($250) Evening Camps ($200) cally and psychologically able to participate fully, except as to the following limita- La Salle Lacrosse Camp. Camp Descriptions place at camp. Confirmation is automatic via email at time of regis- ❒ La Salle High School ❒ S4 @ La Salle H.S. tions (none will be assumed unless listed) tration/payment. June 22-26, 2009 June 15-18, 2009 _____________________________________________________. Sincerely, Day Camp 9:00 a.m.-2:30 p.m. 5:00-8:30 p.m. In consideration of such admission, we do hereby agree to release, discharge, indemnify and hold harmless US Lacrosse and Quickstick Intensive Lacrosse Camp La Salle High School Fees & Discounts Inc., including any officers, directors, agents, coaches, employees, representatives, 8605 Cheltenham Ave., Wyndmoor 19038 Fees: volunteers, and all sponsors of this event including La Salle High School and the Date: June 22-26, 2009 from 9:00 AM to 2:30 PM (Boys & Girls) _____________________________________________________ Bill Leahy Tony Resch Megan Fortunato The Day Camp fee is $250 for La Salle and $200 for the S4 @ La Salle High owners of any fields on which the camp is conducted. The parties mentioned above The original La Salle Lacrosse Camp location! Since 1993 boys and girls have been Last name First name Middle initial shall not be liable for any injury, loss of life and from all causes, liabilities, dam- Camp Directors ® enjoying camp at La Salle and our camp has grown every year. This camp highlights School which covers camper instruction, STX reversible jersey, lanyard, stick- ❒ Boy ❒ Girl ages, claims or demands whatsoever on account of any injury or accident
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