Herkimer Soccer Booster Club

1
Herkimer Soccer Boosters Camp Registration Form
Herkimer Soccer Booster Club presents
Please return to Glenn H. Manning Herkimer
High School 801 West German Street Herkimer, NY
13350 GManning_at_herkimercsd.org Shirt
Size Adult S M L XL Child S M L XL
Please print Name______________________________
_________________ Address _______________________
______________________ City, State, Zip
________________________________________ Phone
_______________ School ________________________
Age __________________Grade ____________________
____ Person to notify in case of emergency
Name __________________________ Phone
______________
July 13-17, 2009 900 a.m. - 1230
p.m... Herkimer Elementary School Soccer Fields
I being the parent or guardian of the above
named minor, do hereby certify that my
son/daughter is in good condition to participate
in all activities. I hereby appoint the
Herkimer Soccer Booster Club Camp Director to act
in authorizing medical action. Parent or
Guardian Signature ______________________________
_________ No refunds after the program has begun.
2
Peterson Jerome - Coach Jerome was named an NSCAA
college All American in 1997 while playing for
HCCC. After HCCC he transferred to Ohio
State University where he was the leading scorer
in 1998. Peterson was also named to the Soccer
America team of the week in 1999.
Perry Nizzi - Mens soccer Coach and Associate
Professor at Hamilton College. Coach Nizzi is a
two-time NCSAA National Coach of the Year.
Nizzi was also an eight-time Collegiate Regional
Coach of the year. His Soccer teams at Herkimer
County Community College have won THREE
(undefeated) NATIONAL CHAMPIONSHIPS, and hold
the longest collegiate sports winning streak at
97 wins. Perry is an alumnus of SUNY Cortland
where he starred as an All-State midfielder. He
also received his Masters Degree from Cortland.
Dave Carter - Coach Carter was a Division 1
All-American and All Northeast goalkeeper at
Oneonta State University. Dave is now Director
of Goalkeeping for Fuller Hamlet Soccer Club of
Sutton, Massachusetts.
The Herkimer soccer Boosters would like to invite
you To a fun filled week of exciting soccer
demonstrated by The Finest soccer coaches in the
area.
Discount for families with more than
one(1) camper from immediate family is 65.00
Tom Basel Coach Basel is in his 8th year of
coaching the Poland High School Girls Varsity
Soccer Team. He had lead his team to 2
conference titles and to the New York State
Finals in 2000. Tom was a four year starter at
St John Fisher where he was captain and
All-Conference.
Specialized Goalkeeper Training is Available
Participants will receive a Camp T-shirt and
Soccer Ball. Shorts, t-shirts, sneakers or
cleats, soccerball and shin guards are required.
Your own water bottle is recommended. Please put
your name on any items brought to camp.