DePaul Spring College Prep Clinic

DePaul Women's Soccer
Spring College Prep Clinic

Date: Saturday May 15th 2010

Time: 9 am- Noon

Cost: $75

Location: Lincoln Park Turf Field

1778-1972 N John C Cannon Drive

Chicago, IL 60614

Access to the field is through the Lincoln Park Zoo

entrance. Players or parents are responsible for the parking rates that apply.


For High School players only. This one day clinic is designed for players

interested in playing collegiate soccer. Players will have the opportunity to

work exclusively with DePaul Women's Soccer staff. They will be exposed to a

high level training session that mirrors what we do on a daily basis.


Name: _______________________________________ Age/Grade: _______________________

Address: _____________________________________________________________________________

Home Phone: _________________ Cell: __________________ Email: ____________________

Make checks payable to Chastain Soccer Academy.

Health Insurance:

Insurance Company: _______________________________ Provider: ________________________

Pre‐Exist. Condition: ____________________________________________________________________

Allergies: ________________________________________ Medication: ______________________

 I hereby authorize the Staff of DePaul Girl's Soccer Camps to act for me according to their best judgment in any

emergency requiring medical attention and I hereby waive and release the camps and any DePaul personnel from any

and all liability for nay injuries or illnesses incurred while at the Camp. I have no knowledge of any physical

impairment that would be affected by the above named camper's participation in the Camp program, as outlines in

the brochure. I also understand that the Camp retains the right to use photographs of campers taken at the Camps for

publicity and advertising purposes.

Parent or Guardian's Signature: __________________________________ Date: ________________________



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