Multnomah Athletic Club

Sumumblicecramps p 2014 guide to

MULTNOMAH ATHLETIC CLUB

2014 SUMMER CAMPS REGISTRATION FORM • This registration form may be used by non-members for 2014 MAC athletic camps only.

PAYMENT POLICY • Payment must accompany all registrations.

• Use one registration form per participant. This form may be copied, but completed forms must include a completed waiver form (see next page).

CANCELLATION POLICY • All cancellations must be made by the cancellation date listed in the camp descriptions or on the camp confirmation following registration, for a full refund.

• Mail completed registration form(s) to MAC Summer Camps c/o Junior Sports, 1849 SW Salmon, Portland, OR 97205, or drop them off at the Junior Sports Office located between the Main and Climbing gyms. (See camp deadlines in the MAC 2014 Summer Guide to Camps and Classes).

REFUND POLICY • Refunds are granted only if cancellations are made by the cancellation date as described in the camp description. • No prorated refunds are made.

Please print legibly. Name_ ____________________________________________________________________________________ Age__________________________ Parent’s name (if registering a junior)_________________________________________________________________________________________ Check number (of enclosed check)__________________ Address_ _______________________________________________________________________________________________________________ City___________________________________________________________________ State_ ______________ Zip_ _________________________ Phone (day)_ __________________________ (evening)_ _____________________________ (emergency)__________________________________ Email___________________________________________________________________________________________________________________



REGISTRATION NO.

CAMP NAME

DATES

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TOTAL COST:

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The following forms must accompany each registration:

For more information, go to:

• Completed waiver

www.theMAC.com

• Parent’s consent to medical treatment

COST

AGREEMENT RELEASE AND WAIVER OF LIABILITY Revised and Effective Oct. 1, 2013 Name of Participant______________________________________________________ In consideration of the opportunity to participate in Multnomah Athletic Club’s ______________(year/season) class/clinic/event/activity/camp/lesson titled _________________________________________, with event registration no. __________________ herein referred to as ‘‘the program’’ made available through the Multnomah Athletic Club, herein referred to as “MAC,” I agree as follows: 1. I understand and acknowledge that participation in the program may be dangerous and may involve risks which include, but are not limited to, bodily injury, partial or total disability, paralysis and death. I also understand and acknowledge that the social and economic losses or damages which can result from those risks and dangers can be severe and that not all such risks and dangers may be known or reasonably foreseeable at this time. I accept the responsibility for losses or damages resulting from all such risks and dangers involved in participation in the program. 2. I agree to take appropriate precautions for my own safety and that of others when participating in the program and further agree that, before participating I will inspect the facilities and equipment to be used and will, if I believe anything is unsafe, immediately advise the person in charge of that unsafe condition and will refuse to participate. 3. I hereby release, waive and discharge MAC, its coaches, instructors, officials and volunteers engaged by MAC, in the conduct of the program, and MAC officers, directors, agents and employees, from all liability to me and to my conservators, guardians or other legal representatives, assigns, heirs and next of kin for any and all claims, demands, losses or damages on account of any injury, death or damage to property, arising out of my participation in the program, arising from negligence, whether on MAC premises or elsewhere, including transportation of myself and/or my child/ ward to and from events and venues. 4. If competing in an offsite event/venue, I assume responsibility for transportation of myself and/or my child(ren)/ward(s) to and from those events and/or venues. 5. I also hereby agree to indemnify and to hold harmless from any claim or demand on account of injury or damage which I may suffer as a result of participation in the program MAC and all other persons mentioned in Paragraph 3. 6. I understand that this release, waiver and agreement to indemnify and hold harmless includes, but is not limited to, damages which are caused, or alleged to be caused, in whole or in part by the negligence of MAC and the individuals listed in Paragraph 3.

I have read the above agreement of release and waiver of liability and understand that by signing it I have given up substantial rights. I sign this agreement voluntarily. Signature of participant or parent if under 18:_____________________________________ Date:_______________________ If participant is not over 18 years of age, please complete the following: I am the parent or legal guardian of the participant named above, who is under the age of 18 years, and who wishes to participate in Multnomah Athletic Club’s program described above in Paragraph 1. In consideration of Multnomah Athletic Club’s allowing my child or ward to participate in that program, I hereby agree to indemnify Multnomah Athletic Club and all other persons described in Paragraph 3 above, and to hold each and all of them harmless from any claim or demand on account of injury to or damage suffered by my child or ward as a result of participation in that program, whether on Multnomah Athletic Club premises or elsewhere. I acknowledge it is my responsibility to deliver my child(ren) to the program and to pick up my child(ren) promptly upon the scheduled conclusion of the program. If competing in an offsite event/venue, I assume responsibility for transportation of myself and/or my child(ren)/ward(s) to and from those events and/or venues. This agreement includes, but is not limited to, claims or demands on account of injury or damage caused or allegedly caused by the negligence of MAC or any of the individuals listed in Paragraph 3. Signature of parent or legal guardian ____________________________________________ Date:_______________________

Parent’s Consent for Medical Treatment (This form must accompany all junior registrations.) q I wish to provide consent and have completed the form below. Parent’s Name_____________________________________________________________ Acct. No.___________________ –______ Child’s name______________________________________________________________ Acct. No.___________________ –______ Address __________________________________________________________________ City/State___________________ Zip________________ Phone (home)_______________________ (work)_______________________ (mobile)________________________ (other):___________________ __________________________________ I, ______________________________________________, natural parent and/or guardian of _______________________________________, a minor child, do hereby fully authorize Multnomah Athletic Club coaching staff or designated chaperones to act on my behalf in the event my child(ren) is the victim of an accident, injury or illness that requires immediate medical or surgical care. Actions on behalf of my child(ren) shall include but not be limited to authorization for Multnomah Athletic Club coaching staff or other chaperones to arrange for such medical care as they deem appropriate, substantiated by local medical advice, and to give any required consent for such medical care. I acknowledge that it is my responsibility to advise Multnomah Athletic Club, in writing, of any allergies, medical problems or prescription medicine requirements that would be pertinent in the treatment of my child(ren). Parent’s signature_____________________________________________________________ Date:_______________________ Medical Insurance Company Name and Plan No. ________________________________________________________________ Primary Physician Name _______________________________________________________ Physician Phone:______________

BASKETBALL and basketball-specific speed, agility and quickness. This camp is designed to fine tune game fundamentals and is focused on team play. Offensive and defensive systems are coached and put into game scenarios. During the camp, a nutritionist speaks about proper nutrition for athletes and a sports psychologist works with athletes on their mental game, including focus, confidence, pressure and performance. After initial assessments, groups are made based on skill level, not age. This camp is for children with at least two years experience playing on a team. When registering, it is required that you submit your child’s experience. MAC staff may suggest alternative camps to ensure all athletes benefit. For more information, contact Gymnasium Supervisor Van DeKoning at 503-517-7572 or email [email protected]. Register online; for assistance, contact Kellie Halkinrude at 503-517-7575 or [email protected]. BOYS (ages 10 to 14)____________________________ JS003 SU14 Monday, July 28 through Friday, Aug. 1 9 a.m.-1:45 p.m. | MAC Gyms members $227; non-members $273; cancel by Monday, July 21

DAMIAN LILLARD BASKETBALL CAMP MAC is pleased to introduce the Damian Lillard Basketball Camp, featuring NBA All-Star Damian Lillard. While the camp is open to a wide range of ages, the players are organized into teams based on skill level and experience. The camp includes an array of drills, games and scrimmages to help campers develop both their individual games and their teamwork skills. The full-day camp gives campers the opportunity to interact with both Lillard and an array of highly-skilled coaches and players. The goal of the camp is to provide a fun, unique experience for basketball players and help them improve their game. When registering, please submit your child’s experience and playing level to assist in organizing the camp. For more information, contact Gymnasium Supervisor Van DeKoning at 503-517-7572 or email VDekoning@themac. com. Register online; for assistance, contact Kellie Halkinrude at 503-517-7575 or [email protected]. BOYS and GIRLS (ages 5 to 16)_____________________ JS992 SU14 Tuesday, July 8 through Friday, July 11 9 a.m.-3 p.m. | MAC Gyms members $275; non-members $325; cancel by Monday, July 21

BOYS COMPETITIVE BASKETBALL CAMP This year’s boys competitive camp features some highly touted MAC member coaches, including Terry Porter, Nick Robertson, Michael Holton and more. Each day is led by a different coach, who places emphasis on his specialized skill set. The mor ning session emphasizes individual basketball fundamentals

SHERRI MURRELL GIRLS COMPETITIVE BASKETBALL CAMP This camp is led by Sherri Murrell, who is in her seventh season as head coach of the Portland State University women’s basketball team. She has guided the Vikings to their most successful six-year stretch at the NCAA Division I level. Murrell surpassed the 100-career wins mark at PSU in 20122013, becoming just the second coach in Portland State history to eclipse the 100-win mark. Coach Murrell analyzes players’ skills and teaches how to incorporate these skills in team play. During the camp, a nutritionist speaks about proper nutrition for athletes and a sports psychologist works with athletes’ mental game, including focus, confidence, pressure and performance. This camp is for players who have at least one year of experience playing on a team. When registering, it is required that you submit your child’s experience. MAC staff may suggest alternative camps to ensure all athletes benefit. For more information, contact Gymnasium Supervisor Van

BASKETBALL continued

FOOTBALL continued Campers should wear turf shoes or general athletic shoes, bring a small water bottle (with their name on it) and sunscreen. For more information, contact Junior Sports Supervisor Mike Donovan at 503-517-7578 or [email protected]. Register online; for assistance, contact Kellie Halkinrude at 503-517-7575 or [email protected]. BOYS (ages 6 to 13)_________________________________ JS028 Monday, June 16 through Friday, June 20 9-11 a.m. | Lincoln High School members $124; non-members $150; cancel by Monday, June 9

DeKoning at 503-517-7572 or [email protected]. Register online; for assistance, contact Kellie Halkinrude at 503-517-7575 or [email protected]. GIRLS (ages 10 to 14)____________________________ JS305 SU14 Monday, July 28 through Friday, Aug. 1 9 a.m.-1:45 p.m. | MAC Gyms members $227; non-members $273; cancel by Monday, July 21

FOOTBALL NIGEL BURTON FOOTBALL CAMP

NEIL LOMAX FOOTBALL CAMP Neil Lomax, one of Oregon’s all-time greatest football players, heads a popular youth football camp this summer. Lomax is a college hall of fame member who set many NCAA passing and total offense records playing for Portland State University. He was a first-round NFL draft choice by the Cardinals. He had a great NFL career and is considered by most to be among football’s greatest quarterbacks ever. This camp teaches all the fundamentals of football, including proper blocking and tackling, using bags to help prepare youngsters for the upcoming football season. The camp also works with all positions. Boys are divided into age groups and receive instruction on various aspects of the game. This camp is a non-contact camp. Games are built into this camp.

Portland State University head coach Nigel Burton leads this padded football camp. With the help of his staff and current players, Nigel instructs players on the skills to succeed at the sport. The PSU coaching staff has a wealth of experience, which includes two national championships and a Super Bowl championship. This is a unique opportunity to learn all aspects of the sport from some of the most experienced coaches and players in the game. Campers learn the fundamental techniques of their position to compete at the highest level. Campers should wear field turf cleats, helmet, mouth guard, shoulder pads, practice jersey, padded pants, cup and athletic supporter. They should also bring a water bottle (with their name on it) and sunscreen. Campers meet at 9 a.m. at Stott Field, ready for camp, or at 8:15 a.m. at MAC to check in and walk to PSU. For more information, contact Junior Sports Supervisor Mike Donovan at 503-517-7578 or [email protected]. Register online; for assistance, contact Kellie Halkinrude at 503-517-7575 or [email protected]. BOYS (grades K to 8)_________________________________ JS100 Monday, June 23 through Friday, June 27 9 a.m.-1 p.m. | Stott Field (930 SW Hall) members $227; non-members $273; cancel by Monday, June 17

LACROSSE DENNIS SULLIVAN BOYS COMPETITIVE LACROSSE CAMP This summer, experience lacrosse, one of the fastest-growing sports in the United States. MAC boys and their guests get quality individual instruction in basic lacrosse skills and team play. Players learn the basic fundamentals of passing, shooting and dodging, as well as defensive techniques. Games are built into this camp. This camp is designed for players with prior lacrosse experience. When registering, it is required that you submit your child’s experience. MAC staff may suggest alternative camps to ensure all athletes benefit. Dennis Sullivan, the head lacrosse coach at Oregon Episcopal School (OES), heads this week-long camp. Sullivan attended Brown University where he was an All-American, All-Ivy League, team captain and team MVP. After college, he played professionally for the New Jersey Pride. He later coached high school lacrosse in New Jersey and was named the 2002 state coach of the year. Sticks, helmets, shoulder pads, elbow pads and gloves are available at OES if needed. Participants who have equipment are asked to bring it to camp. All campers must bring a mouthpiece, cup, and a T-shirt to fit over their shoulder pads, as well as a water bottle and sunscreen with their name on it. Parents are responsible for transportation to and from OES. There is a lunch break. For more information, contact Junior Sports Supervisor Mike Donovan at 503-517-7578 or [email protected]. Register online; for assistance, contact Kellie Halkinrude at 503-517-7575 or [email protected]. BOYS (ages 8 to 13)_____________________________ JS495 SU14 Monday, July 21 through Friday, July 25 11:45 a.m.-2:45 p.m. | Oregon Episcopal School members $124; non-members $150; cancel by Monday, July 14

HOLLY ZIEGLER GIRLS LACROSSE CAMP Holly Ziegler, head coach of St. Mary’s lacrosse, offers MAC a week of lacrosse instruction and team play. Ziegler has coached the St. Mary’s Blues for the past five seasons, and led them to consecutive state championship titles in 2007 and 2008. A former collegiate All-American and All-Ivy League, Ziegler attended Dartmouth College. For her contributions to lacrosse as a player, coach and umpire, Ziegler was inducted into the Oregon Lacrosse Hall of Fame in 2007. Games are built into this camp. Sticks and goggles are provided; players with their own equipment are asked to bring it. Campers must bring a mouthguard, water bottle and sunscreen with their name on it. For more information, contact Junior Sports Supervisor Mike Donovan at 503-517-7578 or [email protected]. Register online; for assistance, contact Kellie Halkinrude at 503-517-7575 or [email protected]. GIRLS (ages 6 to 10)_____________________________ JS866 SU14 Monday, July 7 through Friday, July 11 2-4 p.m. | Lincoln High School members $124; non-members $150; cancel by Monday, June 30

SOCCER TIFFENY MILBRETT SOCCER CAMP Tiffeny Milbrett is one of the world’s top women soccer players. She had a highly successful collegiate career at University of Portland as the school’s all-time leading scorer with 103 goals, and she won Olympic gold with the U.S. National team. In this camp, boys and girls are divided up into age groups and receive instruction on various aspects of the game. For more information, contact Junior Sports Supervisor Mike Donovan at 503-517-7578 or [email protected]. Register online; for assistance, contact Kellie Halkinrude at 503-517-7575 or [email protected]. BOYS AND GIRLS (ages 6 to 13) Monday, July 21 through Friday, July 25________________ JS304 SU14 9-11 a.m. | Lincoln High School members $124; non-members $150; cancel by Monday, July 14

SOCCER continued BOYS AND GIRLS (ages 8 to 15) Monday, Aug. 25 through Friday, Aug. 29 1-4 p.m. | Providence Park members $227; non-members $272; cancel by Monday, Aug. 18 RECREATIONAL CAMP_____________________________ JS001 SU14 COMPETITIVE CAMP______________________________ JS002 SU14

BERNIE FAGAN SOCCER CAMP Bernie Fagan, a former professional soccer player in England and one of the Northwest’s most respected coaches, leads this camp for the 15th straight year. Fagan was the head women’s soccer coach at Portland State University, and now heads the men’s soccer program at Warner Pacific University. Games are built into this camp. Campers should bring a water bottle with their name written on it, sunscreen, and a snack. For more information, contact Junior Sports Supervisor Mike Donovan at 503-517-7578 or [email protected]. Register online; for assistance, contact Kellie Halkinrude at 503-517-7575 or [email protected]. BOYS AND GIRLS (ages 6 to 13) Monday, July 7 through Friday, July 11_________________ JS056 SU14 9-11 a.m. | Lincoln High School members $124; non-members $150; cancel by Monday, June 30

PORTLAND TIMBERS SOCCER CAMP After a successful two years, MAC’s Portland Timbers Soccer Camp is back and better than ever. Camp is presented in two different styles based on players’ level of experience. The Recreational Camp is designed for children who are new to the sport or have beginning experience. The curriculum focuses on skill development while playing soccer related activities and games in a fun environment. The Competitive Camp is designed for players who are ready to take their game to the next level. Campers are challenged with multiple advanced drills that focus on both individual and team concepts. This camp is for children with at least two years experience playing on a team. When registering, it is required that you submit your child’s experience. MAC staff may suggest the recreational style camp to ensure all athletes benefit. The two camps are held simultaneously on the Providence Park pitch and are led by the Portland Timbers coaching staff with daily appearances from premier players. For more information, contact Junior Sports Supervisor Mike Donovan at 503-517-7578 or [email protected]. Register online; for assistance, contact Kellie Halkinrude at 503-517-7575 or [email protected].

MAC SUMMER CAMPS PLANNER Week 1_____________________________________________ TUESDAY

WEDNESDAY

THURSDAY

Purchase a lunch at Joe’s

Bring a lunch from home.

FRIDAY

MORNING 9-11 a.m.

MONDAY

MIDDAY 11:45 a.m.-1:45 p.m.

Supervised lunch 11-11:45 a.m.

Bring a snack from home.

AFTERNOON 2-4 p.m.

Snack 1:45-2 p.m.

Week 2_____________________________________________ TUESDAY

WEDNESDAY

THURSDAY

Purchase a lunch at Joe’s

Bring a lunch from home.

AFTERNOON 2-4 p.m.

MIDDAY 11:45 a.m.-1:45 p.m.

MORNING 9-11 a.m.

MONDAY

Notes:

Supervised lunch 11-11:45 a.m.

Snack 1:45-2 p.m.

Bring a snack from home.

FRIDAY