spring indoor youth soccer - City of Hopkins, Minnesota

DYNAMO YOUTH SOCCER
Spring 2012
For Ages 3-13
Instruction Provided by: Hopkins Dynamo Soccer Club
Keith Pavelka, Director of Coaching for Dynamo & Varsity Girl’s Coach at Hopkins High School.
Assistant Instructors will be qualified Dynamo coaches and Hopkins High School players.
What we will learn: Players will have a fun action-packed hour while developing their soccer skills.
They will focus on individual skills at stations for the first part of the hour and the session will end with
games. Soccer techniques include: trapping, passing, shooting, dribbling, small-sided games.
Saturday Sessions: March 10, 17, 24, 31, April 14, 21
Tuesday Sessions: March 6, 13, 20, 27, April 3, 10
Dynotot times: 45 minute sessions $40
Sat
8:45- 9:30am
3-5 year olds (Pre-K)
Tues 9:30-10:15am
3-5 year olds (Pre-K)
Tues 10:30-11:15am
3-5 year olds (Pre-K)
Dynomite times: 1-hour sessions $65
Sat
9:30-10:30am
5/6 years (Kindergarten)
Sat 10:30-11:30am
6/7 years (1st Grade)
Sat 11:30am-12:30pm 7/8 years (2nd Grade)
Young Stars times: 1-hour sessions $65
Sat 12:30-1:30pm
U9 & U10
Sat
1:30-2:30pm
U11 & U12 Girls
Sat
2:30-3:30pm
U13 Girls
Sat 3:30-4:30pm
U11 & U12 & U13 Boys
Equipment: Participants will receive a Dynamo t-shirt. Please bring athletic shoes (no cleats),
soccer ball and water bottle. Shin guards are recommended. It is indoors, but dress for cool climate.
Registration:
Dynotots is $40 per child
Dynomites/Young Stars is $65.00 per child (Save $10 – $55 if postmarked before Feb. 1, 2012)
Online: www.eminnetonka.com starting Dec. 1st, 2011
Email: Form available online www.hopkinspavilion.com. Email to pavilion@hopkinsmn.com
Mail or Drop off: Hopkins Pavilion, 11000 Excelsior Blvd, Hopkins MN 55343.
11000 Excelsior Blvd., Hopkins MN 55343 (952) 939-1410
www.hopkinsdynamosc.org
www.eminnetonka.com
www.hopkinspavilion.com
Dynamo Youth Soccer Program
(PLEASE FILL OUT A SEPARATE FORM FOR EACH PARTICIPANT. FILL IN FORM COMPLETELY.)
REGISTRATION FORM
Tuesday Sessions:
Saturday Sessions:
3/5 (Pre-K) – 9:30 am
3/5 (Pre-K) – 10:30 am
3/5 (Pre-K) – 8:45 am
5/6 (K) - 9:30 am
6/7 (1st) - 10:30 am
7/8 (2nd) - 11:30 am
U9 & U10 - 12:30 pm
U11 & U12 Girls - 1:30 pm
U13 Girls - 2:30 pm
U11 & U12 & U13 Boys -3:30
Participant Name:
Home Phone:
Address:
City:
Zip:
Parent’s Name:
Phone:
Email:
Parent’s Name:
Phone:
Email:
Sex:
M
F
School:
Birth date:
Age as of 3/10/2012:
Grade:
*Signature:
Date:
*Signature of Parent/Guardian acknowledges acceptance of waiver and is required for participation.
PARENT/GUARDIAN AGREEMENT: I, the parent/guardian of the registrant, a minor, agree that the registrant and I will abide by the rules of the
Hopkins Pavilion. Recognizing the possibility of physical injury associated with soccer, I hereby release, discharge and/or otherwise indemnify the
Hopkins Pavilion and the Hopkins Dynamo Soccer Club, their employees and associated personnel against any claim by or on behalf of the registrant as
a result of the registrant's participation in the program. As the parent or legal guardian of a participant, I hereby give my consent for emergency medical
care prescribed by a duly licensed Doctor of Medicine or Doctor of Dentistry. This care may be given under whatever conditions are necessary to
preserve the life, limb or well being of my dependent.
DATA PRIVACY ACT/TENNESSEN WARNING: The Minnesota Data Privacy Act requires that the registration information you provide on this form
remain as private data. Private data is available to you but not the public. While you may choose to withhold this private data, there may be
consequences that could limit the distribution of information to the participant (i.e., no team roster or class lists). By signing below, you are consenting to
allow registration information to be shared with the coach, supervisor, or instructor and other registered program participants for the purpose of
administering the activity. This consent will expire upon completion of this activity.
Please check here if you do not wish to allow use of photos of your child for publicity of this program.
Please check here if you do not wish to be included on our mailing list.
$65 Registration Fee (Early Registration Discount - $55 if received before Feb 1, 2012)
$40 for Dynotots, Pre-K 45 minute program (No Early Registration Discount)
Cash
Check #
Please make checks payable to the City of Hopkins
Credit (visa or mastercard) #
exp.
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11000 Excelsior Blvd • Hopkins, MN 55343 • 952.939.1410 (p) • 952.979.0446 (f)
www.hopkinspavilion.com • pavilion@hopkinsmn.com