Clemson University Paralympic Soccer: Veteran Camp Registration, Aug 19-21, 2022

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

Clifton, New Jersey
Aug 19-21, 2022 (Half-day on Friday, Full day Saturday & 5 PM end Sunday)

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 2.5 day soccer clinic hosted by Clemson University Paralympic Soccer.

What you will experience:
1. Gain knowledge and training in adaptive soccer (CP/TBI Soccer and Blind Soccer)
2. Receive US Soccer 7V7 Grassroots Coaching License
3. Receive Mental Health First Aid Certification

Main Goal: Our main goal is to introduce veterans to adaptive soccer. We will provide the veterans with an opportunity to get Coaching and Mental Health First Aid Certified. We will also provide resources for participants wanting to get started.

Please register ASAP, as spots fill up fast!
Participants are responsible for transportation to and from the camp, this includes some walking during the camp. Please bring needed walking assistance IF applicable to you.

Website: clemsonparalympicsoccer.org

Questions? E-mail ddepers@g.clemson.edu

Email *

Full Legal Name (on passport)

Date Of Birth (01/01/19XX)

Address Line (If applicable, please Indicate APT #)

City

State

Zip Code

Phone number (XXX) XXX-XXXX

Email address

Reason for involvement

CP/TBI/Stroke

Visual Impairment/Blind

PTSD

Veteran

Professional working with veterans (Rec Therapist, PT, OT, advocate etc.)

Other:

Clear selection

% Service connected VA disability (for grant funding purposes)

The Military Branch or unit you are/were involved with?

Shirt Size (Adult Unisex)

Which of the following represents your current level of soccer knowledge/skills (select all that apply)?

I have no knowledge or previous experience in playing, coaching, or refereeing soccer.

I have basic knowledge of soccer (i.e., rules of the game, field positions, equipment requirements)

I am knowledgeable/skilled in playing soccer

I am knowledgeable/skilled in coaching soccer (i.e., planning + leading soccer practices related to athlete’s physical fitness, strength training, and soccer-specific drills)

I am knowledgeable/skills in refereeing soccer (i.e., i.e., rules of the game, personal fouls, penalties, etc.)

Where did you hear about us?

List any special accommodations that will be needed (eg. large print, risk triggers, on screen text, etc). Please expand.

Dietary Restrictions (if applicable).

I will...

be commuting

need lodging

Clear selection

By 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

Yes, I understand this

No, please do not include me in this program as I am not 100% committed.

Clear selection

Submit

Clear form

Never submit passwords through Google Forms.

This form was created inside of Clemson University. Report Abuse

Forms