Lebanon Valley C ollege

2009
FOOTBALL
Insurance Form
Must be completed by parent/guardian
Medical Insurance Information
Company Name____________________________________
Date of last tetanus shot ____________________________
I approve my child’s attendance at the Lebanon Valley
College Football Camp and certify that he is in good
health. If medical attention is required for illness or injury
during camp, I grant my permission for such care to be
rendered. I hereby recognize and understand that the
College, the camp director, and/or coaching staff are not
responsible for any injury of any kind that may occur on
the way to, during, or on the way home from any camp
session sponsored by Lebanon Valley College.
Authorization for Emergency Service
A.) I do hereby voluntarily consent to examination and
emergency service treatment including the administration
of such drugs, infusion, and transfusion of blood or blood
components deemed necessary in the judgement of the
physician(s) (and whomever may be delegated as assistants) of the medical staff of the Good Samaritan Hospital.
B.) I certify that I have read and fully understand the consent given herein. I also certify that no guarantee or assurance has been made as to the results that may be
obtained. The undersigned intends to be legally bound
hereby.
Note any limitation on the foregoing __________________
__________________________________________________
____________________or if none, so indicate __________
______________________________________________________________________________________________________________________________________________
Date
Authorized Signature
______________________________________________________________________________________________________________________________________________
Relationship
Emergency Contact Information
Name ____________________________________________
Home Phone (
) ______________________________
Work Phone (
) ________________________________
Cell Phone (
) ________________________________
LOCATION AND HOUSING
The Lebanon Valley College Football Camp is
conducted on the LVC campus in Annville, Pa.
Resident campers will be housed in modern residence
halls, which are supervised by camp counselors.
Campers need to bring their own bed linens, soap,
towels, face cloths, clothes hangers, swimsuits, and
other personal items. Helmets and mouthpieces must
be worn during practice. Laundry facilities are available in the residence halls.
DIRECTIONS
The camp is located on the campus of Lebanon
Valley College in Annville, Pennsylvania, only minutes from Hershey. From Route 81, take Route 934
south. From the east or west, take either Route 422
or 322 to the Lebanon-Annville area. Turn north at
the intersection of Routes 934 and either 422 or 322.
Lebanon Valley College
Policy No. ________________________________________
AN AW ESOME STAFF
TEAM CAMP
CAMP
This football camp is for serious football players who
have completed 8th grade but not yet graduated from
high school.
CAMP FEATURES
• Quality residence halls
• Swimming
• Weightlifting
• Guest speakers
• Videotape analysis
• A night at Hersheypark for overnight campers
• Indoor practice facility for inclement weather
WEEK 1: July 12–15
WEEK 2: July 19–22
Facilities
• Five, 100-yard practice fields located together
• Large weight room
• Indoor practice facility
• Six-lane swimming pool
• State-of-the-art training room
Jim Monos, Head Football Coach at LVC
The former offensive coordinator and quarterbacks coach at Bloomsburg University, Monos
enjoyed a highly successful run with the Huskies
from 1997–2003. He helped lead Bloomsburg to a
56-23 record and a 36-6 mark in Pennsylvania State
Athletic Conference (PSAC) Eastern Division play.
The Huskies also won five PSAC East championships
during Monos’ tenure and reached the NCAA
Division II playoffs twice, including an appearance in
the national championship game in 2000. Monos
helped the Huskies establish a reputation as one of the
most dangerous offensive teams in the PSAC.
At Lebanon Valley, the Flying Dutchmen finished
64-93-2 in 16 years under Monos. In 2006, Monos led
LVC to a 6-4 record. This was the first winning season
since 1992. He led the Valley to a 6-3-1 record in
1991 and a 7-3 mark in 1992, the team’s first back-toback winning seasons since 1978-79. In 1989, he was
named as the Middle Atlantic Conference Co-Coach
of the Year after leading the Dutchmen to a 6-4 record.
Prior to taking over the head coaching spot at
Lebanon Valley in 1986, Monos was the offensive
coordinator at Shippensburg University for seven seasons, following three years as a part-time coach. He
earned all-conference honors in both football and baseball at Shippensburg before graduating in 1972. A
native of Shippensburg, Monos is a member of the
Shippensburg University Athletic Hall of Fame.
Joe Buehler, offensive line coach and offensive coordinator, LVC; 20 years of coaching experience; 1989
graduate of LVC
Mike Donghia, defensive coordinator, LVC;
28 years of coaching experience; 1979 graduate of
Edinboro University
Tom McKee, wide receiver coach, LVC; 2004
graduate of Bloomsburg University
FOOTBALL CAMP
REGISTRATION FORM
EXP ERIENCING A JIM MONOS-RUN CAMP
“Coach Monos runs a complete camp that enables
you to develop your team in all phases of the game.
Our players take great pride in coming to this camp.”
— Patrick Conrad, HFC, Red Lion High
School
Camp Desired (please check one):
❑ July 12–15 Camp
❑ July 19–22 Camp
Commuter or Resident (please check one):
❑ Commuter, $180 (without trip to Hersheypark)
❑ Resident, $280 (includes trip to Hersheypark)
“I have had the sincere pleasure of attending Coach
Monos’ camps as both a player, and now as a head
coach. Our players look forward to the camp annually. Each year, the camp proves to be invaluable in our
fall preparations. I can truly say that the LVC camp
experience is the best around.”
— Matt Muller, HFC, New Oxford High
School
Name
Social security number
Name of parent/guardian
Mark Costello, running backs coach and special
teams coordinator, LVC 2004; graduate of Susquehanna
University
Vince Pantalone, inside linebackers coach, LVC; 29
years of coaching experience; 1977 graduate of
Moravian College
Lou Orndorff, outside linebackers coach, LVC; 37
years of coaching experience; 1969 graduate of
Shippensburg University
Guy Bennardo, tight ends coach, LVC; 12 years of
coaching experience; 1982 graduate of Juniata College
Mike Wildasin, defensive line coach, LVC; 38 years
of coaching experience; 1969 graduate of Shippensburg
University
Corey Wenger, defensive backs coach, LVC; 11 years
of coaching experience; 1998 graduate of the University
of Miami, Fla.
Matt Gross, running backs coach, 1997 graduate
of LVC
Larry Minney, kicking coach, LVC
“Coach Monos and staff continue to run an exceptional camp. Lebanon Valley is the perfect setting to get
your upcoming season off to a great start.”
— Jon Defoe, HFC, Bermudian Springs High
School
“This is one of the best camps on the east coast. It is
proven to fulfill your goals.”
— Chuck Tinninis, HFC, Greencastle High
School
“Coach Monos runs a top notch ‘TEAM’ camp.”
— Joe Pearson, HFC, Solanco High School
“The LVC camp provides us with a true team camp.
It is not just 7 on 7; you can work with your whole
team.”
— Frank Gay, HFC, Red Land High School
“Coach Monos and his staff do an excellent job of
meeting our needs for the best camp experience possible. The LVC facilities are outstanding; we had plenty
of field space, access to the weight room, and their
pool, which maximized our time spent at LVC.”
— Mark Evans, HFC, ELCO High School
CANCELLATION/REFUND P OLICY
CAMP RULES
All cancellations must be received in writing or by
fax. Refunds, minus a $20 administrative fee, will be
made for cancellations received at least 15 days prior
to the beginning of the camp. After this deadline,
$60 will be deducted from the refund. If a cancellation is not received prior to the camp’s starting date,
$90 will be deducted from the refund. Refunds for
campers who leave before the last day of camp will be
based on the cost of housing, meals, days of instruction, and a $60 administrative fee.
Campers are expected to attend all sessions scheduled and to abide by the College’s rules. Specifically,
smoking tobacco, possession, or consumption of illegal drugs, and the use of alcoholic beverages are
strictly forbidden. Flagrant misconduct will result in
the immediate dismissal of the camper without
refund of camp fees.
Resident campers are not permitted to drive their
personal vehicle while enrolled in camp. Keys to private vehicles must remain in the custody of the director for the duration of camp.
MEDICAL INSURANCE
The College does not provide medical insurance
for campers. In the event of illness or injury requiring
treatment, hospitalization, or surgery, family medical
insurance must be used. Campers should be covered
by some form of personal medical insurance. Be sure
to provide your insurance company’s name and policy
number on the registration form. Timely notification
for insurance claims is important, so please include
daytime and home phone numbers, and your physician’s name and phone number on the registration
form.
Address
DAILY SCHEDULE
6:30 a.m. – 7:30 a.m.
8:30 a.m. – 10:30 a.m.
11 a.m. – 12 p.m.
2 p.m. – 4 p.m.
4:30 p.m. – 5:30 p.m.
6:30 p.m. – 8 p.m.
9 p.m. – 10 p.m.
Breakfast
Practice
Lunch
Practice
Dinner
Practice
Camp Meeting
City
State
Home phone
Emergency phone
Grade next fall
Zip
Age
School
Name of coach
T-shirt Size: (please check one)
❑ S ❑ M ❑ L ❑ XL ❑ XXL
DEP OSITS
Complete the registration form and return it with a deposit
of $100 (make checks payable to Lebanon Valley College)
to: Football Office, Arnold Sports Center, Lebanon Valley
College, 101 North College Avenue, Annville, PA 170031400. Registration and full payment is due July 1. Late
registration (after July 1) will incur a $15 late fee.
INSURANCE FORM ON THE BACK OF THIS FORM
MUST BE FILLED OUT BY A PARENT OR
GUARDIAN.
Any refunds will incur
a minimum $20 administrative fee.
MAKE CHECKS PAYABLE TO
LEBANON VALLEY COLLEGE

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