7:37:29 AM 7:37:29 AM n 7:37:29 AM m o 4 d o s c a 1 . k a o s 0 r e p . R M s 2 a . c m l e e , n P r a P n e r R p I c o 8 v r o , 0 i p r P e e t s . e 3 e c H s : a p L c c E g c y o 4 d t c c m o s o o u l x m – a o L e o e B . v P A C c S G p l e N l Presents a r M o t t – n m . e s o i o c a P e U 4 e h c C The l C o c 0 . W S h S S 3 S g i : .thenex 1 h w u U 7101 A ww Hig s n n ’ ) e e l o o t r i s o h ) l a . d o a n w e n s h o c o d d c y a r l e s t l o a i u s p m u r o e a g d o h v e i n i s n b t r n r a i s c l p u r h l e 0 i o e S 2 n p y y w . s e t a r t e l v x a 0 u i r e P e 2 p g n ( g . r t i s e l e s e l e n r b h c a i o t h i f i b t l t l s c n i a e s a e h r e h w t h g s t p i t n , l n i w . l y d . r o r e a g n b i . s a i t u a s r r ( j d a s e l o r r e f : y m u y t e t c r t a o s a e t y n i l a e h r e n t n s g p w o e u t e m e s a r a o g r h p m t c i e d n g / y a i y n u l n s d c a i a m q r l r n a e a a l b m a E P e h E p t t Ac t iv it ie s Pa rt ic ip a ti o n & E me r g e n c y M e d i c a l P e r m i s s i o n Pa r t i c i pa n t ’s Na me : __ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ ( A d d r e s s ) ( P h o n e ) ( P a r e n t P h on e ) Pa r en t( s ) St a t e m en t : I co n s e n t to my s on ’s pa r t i c i p a t i o n in Th e Ne x t L ev e l So c c e r C am p s, In c. I he r e b y au t h o r i z e th e Co a ch in g S ta f f of T he Ne x t L ev e l So cc e r Ca m p s, In c. to ac t ac c or d in g t o th e ir be s t ju d g m e n t in an y em e r g e nc y re q u i r i n g me d i c a l at t e n t i on . A r ec en t p hy s i c a l e x a m i n at i o n f o r m y s o n i n d i ca t es no r ea s o n h e s h o u l d n o t p a r t i c i p a t e i n t h e ac t i v i t i e s o f t h e c a m p . __ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ ( A l l e r g i e s ) ( S p e c i a l M e d i c a t i o n s ) Pa r e n t ’ s S ig n a t u re : __ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Da t e : __ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ I n c as e o f em e r g en cy i f p a re n ts ca nn o t b e r e a c h ed , ca ll : __ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ ( N a m e ) ( R el a t i o n s h i p ) (P h o n e N u m be r ) - e _ _ _ y d n _ _ _ _ i l l _ _ _ r e o i _ _ _ _ b i _ _ _ e r CAMP DIRECTOR: d t _ _ _ _ The Cost : $225.00 a _ _ _ v a n a _ _ _ _ d t _ _ _ l u y l _ _ _ _ _ _ _ n n Bob Spielmann is the founder of the High School Super f r e _ _ _ e . u u _ _ _ _ c u l f _ _ _ The Fee Includes: r j Camp which is entering its 23rd year of existence. Coach 4 _ _ _ _ o e n _ _ _ 1 n s _ _ _ _ r v _ _ _ a i Spielmann is currently the Director of Coaching at Bavarian i - 0 c _ _ _ _ _ _ • Camp T-shirt _ , r 2 o n _ _ _ _ _ Soccer Club. Prior to being at BSC, Spielmann was the DOC _ _ e o o , h a _ _ _ e _ _ _ _ 8 n • Quality Training Sessions s _ _ _ f f of Elm Grove SC, Associate Head Coach at UW–Milwaukee w _ _ _ _ s _ _ _ I 0 T e e _ _ _ _ s _ _ for two seasons. He came to UWM from Marquette _ . 5 v S • Athletic Trainer (present at all times) r n _ _ _ _ _ _ _ t i l $ e _ _ _ t s l _ _ _ _ U University High School in Milwaukee, where he spent 27 sea - i ) p _ _ _ e a e _ _ _ _ G e r _ _ _ sons as head coach.