2010 BOB BARRY GOALKEEPER CLINIC AGES Ages 8+ and above. Participants will be grouped according to age and ability. ALL keepers will participate in the FULL DAY activities. DATES & LOCATION Clinic #1 Honolulu July 24-25 @ Damien High School Clinic #2 Mililani July 31- August 1 @ Mililani Mauka Community Park 8:30-9:00 a.m. (First day) Complete Registration ALL AGES 9:00 a.m. – 3:30 p.m. COST $130.00 Each participant will receive a Clinic T-shirt, Clinic ball, a copy of Winning Goalkeeper Training and a written evaluation of the 2 day training. Contact Director Bob Barry for additional information Bob Barry (808) 236-4515 (808) 265-4249 barryr003@hawaii.rr.com Clinic Registration Form Name _____________________________________________ Age_______________ Ht.____________ Wt.______________ Name of parent or Guardian___________________________ Home Address______________________________________ City_____________________________ State_____________ Zip Code____________ Home Phone____________________ Email______________________________________________ School Currently Attending____________________________ Grade________ Soccer Experience (Years) ______________________ Family Physician_____________________________________ Phone_______________ Medical Plan___________________ Circle Shirt Size: Men's S M L XL Circle Session(s): Session #1 Honolulu July 24-25 @ Damien High School Session #2 Mililani July 31-August 1 @ Mililani Mauka Community Park Please send registration fee or $40.00 deposit with balance due at registration, made payable to: Bob Barry 44-130 Kou Place #7 Kaneohe, HI 96744 I hereby authorize the Goalkeeper staff to act for me according to their best judgment in any emergency requiring medical attention. ________________________________________ Signature of Parent or Guardian