EmailMe Form - USAi Hosts: USC 4v4 & 7v7/9v9 Coaching Courses!

USAi Hosts: USC 4v4 & 7v7/9v9 Coaching Courses!

DATE: SATURDAY FEBRUARY 24, 2018
LOCATION: PIKE HIGH SCHOOL ATHLETIC BUILDING
INSTRUCTOR: VINCE GANZBERG
COST: FREE FOR USAI COACHES

USAi Coaches may take ONE or BOTH courses for FREE! We strongly encourage you to take both if you can. Course descriptions and mandatory registration form below!

***There is a commitment from each candidate to continue to coach at USA of Indiana in 2018. If a candidate takes the course and then doesn't coach, the Club reserves the right to deduct the $50 (4v4) and/or the $75 (7v7/9v9) cost of the course from the coach's stipend. I agree to allow the Club to deduct the cost of the course should I decide not to continue coaching in 2018.***

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9am-Noon: 4v4 COURSE

Designed for coaches with players ages 8 and under. The curriculum is packed with age-appropriate training activities around a 4v4 game structure.

Time Commitment: Up to 3 hours in person plus additional online course content

Testing: No

Prerequisites: None

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1pm - 5pm: 7v7 and 9v9 COURSE

Combined course is focused on the 9-12 year old player. Content highlights player development, principles of play, technique, and tactics with small-sided games.

Time Commitment: Up to 6 hours in person plus additional online course content.

Testing: No

Prerequisites: None

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Name *
First Last
WHICH COURSE(S) ARE YOU REGISTERING FOR?
Phone 1 *
### - ### - ####
Phone 2 *
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Address *

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region
Email *
Date of Birth: *
MM / DD / YYYY
Gender: *
Are you a U.S. Citizen? *
Primary Coaching Area: *
Primary Role: *
I Coach: (Males or Females or Both): *
Coaching Positions (list current first and include years): *
Previous Coaching Certifications (include level and year): *
Emergency Contact: *
First Last
Emergency Contact Phone 1: *
### - ### - ####
Emergency Contact Phone 2: *
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Emergency Contact Address: *

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region
Emergency Contact Relationship: *
Medical Insurance Carrier: *
Medical Insurance Policy Number: *
Do we have permission to take you to the hospital if necessary? *
Do you have any known allergies or sensitivities? *
If an allergy or sensitivity is selected, please explain in further detail: *
I agree and understand that United Soccer Coaches (USC) has explained that the coaching Academy program is physically demanding and I represent that I am physically able to participate fully in the Coaching Academy program. I hereby agree to save and hold harmless the USC, its staff, including coaches and each of its officers and directors (the persons and entities released hereinafter being referred to individually and collectively as USC) against loss or damage for any injury illness, or other condition arising out of my participation in the Coaching Academy program, and I hereby release, waive and forever discharge USC from any and all claims which may be made by or on behalf of me arising out of my participation in the Coaching Academy program. (PLEASE DIGITALLY SIGN YOUR NAME BELOW). *