14 th Annual Camel Lacrosse Camp Sponsored by aelacrosse

1. APPLICATION (Please fill out a separate application for each camper) Please check appropriate box indicating the amount you have enclosed with your application. PLEASE PRINT One week cost $200.00_________ Deposit $100.00__________ Two or more in family @ $175.00each__________ GOALIE DISCOUNT $100.00__________ Note: No other discounts apply to goalies. NAME_____________________________________Phone(Home/Office)__________________________ ADDRESS__________________________________CITY/STATE/ZIP___________________________ E-MAIL____________________________________ HEIGHT______ WEIGHT_______ AGE (as of 7/20/09)______ POS_____ YRS EXPER ________ GRADE IN FALL ‘09_______ PARENT/GUARDIAN SIGNATURE __________________________________________ Signing here indicates your agreement to allow the camp to provide emergency and routine medical care for your child. This is also a consent form that says you are aware of the inherent risks associated with a contact sport such as lacrosse. You also agree that your child will heed all rules and regulations of the camp or face dismissal without refund. Make checks payable to: ATLANTIC ELITE LACROSSE 14th Annual Camel Lacrosse Camp Sponsored by www.aelacrosse.com Please return application with deposit or full payment to: Dave Cornell, Director Men's Lacrosse Office 270 Mohegan Ave. New London, CT 06320-4196 Remember the dates for next Summer! JULY 19-23, 2010 EQUIPMENT NEEDED All campers must have helmet, arm or elbow pads, shoulder pads, soccer-type or molded rubber cleats, mouthpiece, gloves and stick. hockey helmets w/mask are OK, as are hockey shoulder pads. Note: The camp does not provide loaner equipment. Try Replay Sports or ask local youth camp directors to direct you to children who have equipment in your town who may not be attending. Boys Ages 8-14 July 20-24, 2009 Note: Schedule is subject to change. For inclement weather, camp will be held in Luce Fieldhouse. If we can’t notify you in advance, a coach will be waiting by fields at 8:45 am to instruct you to drop campers at Luce Fieldhouse. We will only go inside in the event of an electrical storm or a downpour. If the weather is too hot, we will continue with regular a.m. schedule and provide an ample number of water breaks in the shade. The P.M. session could start later if we keep the campers in the Fieldhouse longer to avoid sun exposure. STATE CERTIFICATION: The Camel Lacrosse Camp is fully licensed by the State of Connecticut. The camp is staffed by medical personnel and pool personnel approved by the State. COST: $200.00 for the week. Discounts include $175 per camper for 2 or more from same family and for Conn College faculty and staff families. GOALIES are discounted $100! (They must play goalie for the entire camp). You can register up until July 10th, 2009, but earlier is better for the camp planning. DEPOSIT: A $100.00 deposit must accompany your application to ensure your spot in this increasingly popular camp. This deposit of $100 is non-refundable after July 3rd, 2009. REFUNDS: If you decide not to come to camp after paying in full or a deposit before July 3rd, you will receive a full refund. If you pull out of camp, but do not notify camp prior to July 3rd you will forfeit the deposit. If you come to camp and then pull out, you forfeit deposit. Dave Cornell Men’s Lacrosse Coach CONNECTICUT COLLEGE 860-439-2564 (Office) 860-439-2516 (Fax) dcornell@conncoll.edu

2. CAMP DIRECTORS Dave Cornell - Head Coach Connecticut College Coach Cornell became the 4th head coach in the history of the program after spending two season as the defensive coordinator at Notre Dame. While at Notre Dame, Cornell coached a defense that lifted the Irish to the 2006 NCAA playoffs. Cornell’s coaching career began at Gettysburg College where he spent four years as an assistant coach after being a 2-time All-American midfielder for the Bullets. He was named the head coach at Muhlenburg College in 2001 where he started the program from scratch and recorded wins in their first two seasons as a varsity program in 2003 and 2004. Topher Grossman ’05 - Asst Coach Connecticut College Coach Grossman returned to his alma mater in the summer of 2007 after coaching stints at Adrian College and the Trinity-Pawling School. Grossman was voted MVP 3-times by his teammates for his work in net for the Camels. He garnered All-American as well as Academic All-American honors during his senior season. Coach Grossman is the Offensive Coordinator for the Camels. Dave Howes ’93 - Asst Coach Connecticut College Coach Howes rejoined the Connecticut College lacrosse program in the fall of 2007 after years at the helm of the Fitch High School men’s varsity lacrosse team. Howes is a teacher at the ISAAC School in New London and is the Defensive Coordinator for the Camels. THE PROGRAM The Camel Lacrosse Camp combines an emphasis on individual skills with a progression of small-sided team concepts into controlled scrimmage/game situations. Depending on the enrollment in each camp, campers are divided by age and ability to make an appropriate experience. Our wealth of fields on campus allow us to break down camper groups for the best learning environment. The following are highlights of the lacrosse program: CAMP STORE/LUNCH Each day campers will have a choice to bring a lunch or order a pizza or grinder from a local restaurant. Lunches will be refrigerated by camp staff at drop-off time. Orders will also be taken at drop-off time. Orders must be prepaid. The Camp Store will be open daily offering soda, juice, candy, and chips. Lacrosse specialty items will also be available: t-shirts, shorts, tank tops, hats, and visors. • Individual skills, including goalie work • Video • Team concepts • Indoor box games • Outdoor games SPECIALTY TOPICS Face-off Play Shooting Individual D/O Crease play (D/O) The Lax Challenge : fastest shot, longest throw, most accurate shot. CONNECTICUT COLLEGE OFFERS The beautiful New London campus has some of the most aesthetically pleasing facilities among all New England colleges. We use all of these facilities, especially off-the-field at the hottest part of the day. They include: DAILY SCHEDULE: 8:45am Drop off at Fields 9:00am ON FIELD- skills 11:00am End AM session 11:15-12:40 Pool, Lunch, Video 12:45pm Specialty Talks 1:30pm ON FIELD- team concepts 3:00pm End PM teaching session 3:15-4:15pm GAMES 4:15pm Pick up at Fields • TURF FIELD - SILFEN FIELD • 9 fields all overlooking Long Island • Sound! • Dayton Ice Arena (indoor lax) • Conn College Lott Natatorium (pool) • Fitness & Wellness Center • Charles B. Luce Fieldhouse • *3 indoor courts that • form an indoor field • *Locker Rooms for campers • *Air-conditioned meeting room • for video viewing/analysis CAMP PHILOSOPHY Teaching is the philosophy of this camp. Our experienced staff has been selected for their ability to teach. Our coaches are experts in lacrosse and are committed to our philosophy. It is our goal that through our camp you will make significant strides towards becoming a more confident, informed, and skilled lacrosse player. Our commitment to a low staff:camper ratio supports our mission (2008 ratio was 1:8). SWIMMING There will be a recreational swim session each day supervised by certified lifeguards. This is for SWIMMERS ONLY. Bathing suit and towel must be provided. The swim session is normally after the AM session.

3. POTASSIUM IODIDE (KI) FACT SHEET AND PERMISSION FORM The State of Connecticut is making Potassium Iodide tablets (KI) available to child care facilities and youth camps within the 10-mile emergency –planning zone around Millstone Power Station in Waterford, CT. KI is a form of iodine. It helps to protect the thyroid gland when there is a chance that you might be exposed to a harmful amount of radioactive iodine. In the rare event of a nuclear emergency, your child care provider will be directed when to administer KI through the Emergency Alert System (EAS). Children in child care and youth camps are of the age most likely to suffer the effects of radioactive iodine. Your childcare program or youth camp must obtain your written consent in order to administer KI pills to your child/children. Please remember that the administration of KI to your child under these emergency conditions is voluntary. Contraindications: *Your child should not take Potassium Iodide if he/she is allergic to iodine. *Your child should not take Potassium Iodide if he/she has chronic hives. *Although a single tablet of KI should be tolerated by most people, some (particularly adults), with a number of rare diseases and conditions should discuss this issue with their physicians. These conditions include: *Hypocomplementemic vasculitis, possibly as a component of lupus or chronic hives, *Autoimmune thyroid disease, such as Graves disease. Potential side Effects: Please consult with your pediatrician if your child experiences any of these side effects: *Minor upset stomach *Rash POTASSIUM IODIDE (KI) CHILD MEDICATION AUTHORIZATION FORM Name of Child:__________________________________ Date of Birth:__________________ Street_______________________________________________________________________ City:_________________________________ State:_______ Zip:______________________ Please indicate your authorization or refusal by marking the appropriate line below: _______YES, I want my above named child to be administered KI by my provider when: The Governor declares a nuclear emergency, AND individuals in specified area, that includes this child care facility/youth camp, are advised by the Emergency Alert System (AES) to take the Potassium Iodide (KI) tablets AND I understand that the ingestion of Potassium Iodide (KI) under these circumstances is voluntary. _______NO, I do NOT want my above named child to be given Potassium Iodide (KI) by my provider in the event of a nuclear emergency. I have been advised in writing by the facility about the contraindications and the potential side effects of taking Potassium Iodide. I understand that it is my responsibility to notify my provider in writing if I desire to change my authorization as indicated above. _________________________________________ ___________________ (Parent/Guardian Signature) (Date)

4. STATE PROCEDURES REGARDING MEDICATIONS Campers must surrender all medication, EVEN OVER-THE-COUNTER MEDICATION (i.e.Tylenol, Advil, etc) to our Medical Staff at check-in, to be placed in a locked medical box for the duration of the camp. Campers may self-administer prescribed medications when needed with documented parental and authorized prescriber permission. Prescription medications must be in pharmacy prepared containers and labeled with the name of the child, name of the drug, strength, dosage, frequency, authorized prescriber or dentist’s name and date of the original prescription. Over-the-counter medication must be in the original container and labeled with the child’s name. I hereby request that the following medication be self-administered by: ___________________________________________________, during Camel Lacrosse Camp. (PLEASE PRINT CAMPER’S NAME) (DATE) I understand that I must supply the youth camp with the prescribed medication in it’s original container and properly labeled by a physician/pharmacist. Over the counter medication shall be labeled with the child’s name by the Parent/Guardian(s) at check-in. I understand that this medication will be destroyed if not picked up within (1) week following the end of this session of camp. Name of Medication:______________________________________________________________ Times of Administration:_____, _____, _____ Dates of Administration: ___/___/___ to ___/___/___ Is this a controlled drug?__________________ Authorized Prescriber or Dentist Information: Name (PRINT):_________________________________ Phone #:_____________________________ Street Address:____________________________ City/Town:______________________ State:_____ Authorized Prescriber or Dentist Signature:________________________________________________ Parent/Guardian(s) Name (Printed):____________________________ Parent/Guardian(s) Signature:_________________________________ Relationship to child:________________________________ Phone Number:_________________