MANCHESTER, NEW HAMPSHIRE: Veterans Adaptive Soccer Camp Registration
Dates: July 30-August 1
Point of Contact: Kirsten Windbiel (

Injured Military veterans or members of the Armed Forces (PTSD, TBI, visual Impairment given preference) and workers providing supportive roles for veterans are invited to attend this 3 day soccer clinic.

Please note: Transportation to-and-from camp will be at the participant's expense. Lodging will be provided on a case-by-case basis and will be dual occupancy.

What you will experience:
1. Gain knowledge and training in adaptive soccer (CP/TBI Soccer and Blind Soccer)
2. Receive US Soccer Coach Grassroots Certification
3. Receive Mental Health First Aid Certification
4. Attend a fun community event
5. Exposure to alternative adaptive sport experiences
6. Lunch and dinner provided each day of camp

Main Goal: To introduce veterans to adaptive soccer and provide them with an opportunity to get a Coaching and Mental Health First Aid Certification. We will also provide resources for participants that want to get involved within their own communities after camp.

Camp is limited to a maximum of 14 veterans and/or professionals. Register early!
Full Legal Name (on passport) *
Date Of Birth (01/01/19XX) *
Address Line 1 *
State *
Zip Code *
Phone number (XXX) XXX-XXXX
Email Address *
Emergency Contact Name *
Emergency Contact Phone Number (XXX) XXX-XXXX *
Disability type for Soccer Identification *
% Service connected VA disability (for grant funding purposes) *
The Military Branch or unit you are/were involved with?
Shirt Size (Adult Unisex) *
Reason you would like to be included in this VA adaptive soccer camp and US Soccer Coaching Certification
Which of the following represents your current level of soccer knowledge/skills (select all that apply)? *
Where did you hear about us?
List any special accommodations that will be needed (eg. large print, food restrictions, pet friendly room, risk triggers, etc) *
Will you commute to camp, or do you need a hotel room? *
Have you been vaccinated for COVID-19 (and can you show us proof)?
Clear selection
Are you willing to take a COVID-19 test 2 (or fewer) days before camp?
Clear selection
Any other questions or comments
But submitting this form, I understand, if selected, I am committed to be in attendance the full camp period and will complete the necessary coaching certification material provided PRIOR to attending the clinic *
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