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DePaul Spring College Prep Clinic
DePaul Women's Soccer 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.
Registration: 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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