www.FCMirage.com
847-732-1052
2015 FALL INDOOR SOCCER CLINICS
(BOYS & GIRLS)
SECTION I: U7 – U10
Dates
Monday Nov. 9
Thursday Nov. 12
Sunday Nov. 15
Monday Nov. 16
Thursday Nov. 19
Monday Nov. 23
Times
4:30 pm – 5:30 pm
4:30 pm – 6:00 pm
2:30 pm – 4:00 pm
4:30 pm – 6:00 pm
4:30 pm – 6:00 pm
4:30 pm – 5:30 pm
SECTION II: U11 – U14
Dates
Monday Nov. 9
Thursday Nov. 12
Sunday Nov. 15
Monday Nov. 16
Thursday Nov. 19
Monday Nov. 23
Times
5:30 pm – 6:30 pm
6:00 pm – 7:30 pm
4:00 pm – 5:30 pm
6:00 pm – 7:30 pm
6:30 pm – 7:30 pm
5:30 pm – 6:30 pm
6 INDOOR SESSIONS: Four 1.5-Hour Clinics & Two 1-Hour Clinics
COST: $160 per player (All new players receive an FC Mirage T-Shirt)
DISCOUNTS: Players from the same family? Take 10% off of younger player’s fee
All existing FC Mirage players receive 20% off
Location & Directions: Indoor Gym at the Glenview New Church
74 Park Drive, Glenview, IL 60025
From 94(41) take Lake Ave. Exit west to Shermer Rd. & turn right on Glenview Rd. Turn right
on Park Drive then go left at the “T.” Parking is located on the northwest corner of the church in
front of the gym.
Clinics Overview: The purpose of these clinics is to help all players who desire to become
better soccer players. The overall goal is to provide assistance to players who want to further
their progress in soccer by strengthening their basic skills, foot-eye coordination, balance,
endurance, decision-making, as well as overall game play. Serving as a low-pressure
introduction to travel soccer, new players have integrated into existing teams through attending
indoor clinics. Existing players attend clinics as a way to continue growing during the off-season.
What to Bring: Indoor soccer shoes, soccer shorts, shin guards, and a soccer ball
Registration and Payment: Email to [email protected] including which section(s)
you would like to attend. Fill out and print the Registration form below and bring with your
payment in cash or check (make checks payable to FC Mirage) to the first clinic date that you
attend.
F.C. MIRAGE SOCCER
2015 Indoor Soccer Clinic
Registration and Consent Form
Note: Existing Mirage players do not need to fill out this form
Player’s Name: ________________________________________________
Date of Birth: _____________ Gender:  M  F Phone: _____________
Address: ______________________________________________________
City: __________________________ State:______ ZIP: _____________
Mother’s Name: _________________ Cell Phone: ____________________
E-mail: ________________________ Work Phone: ___________________
Father’s Name: __________________ Cell Phone: ____________________
E-mail: ________________________ Work Phone: ___________________
Emergency Contact: ___________________ Phone: ___________________
Previous Soccer Experience:
Positions Played: ________________ Previous Clubs: _________________
Does the player have any disabilities, handicaps, present injuries, or limitations, allergies,
hemophilia, heart condition, history of respiratory illness or any other significant medical illness
that might affect his or her participation in the sport of soccer?
 NO  YES (please explain) _____________________________________________
________________________________________________________________________
________________________________________________________________________
Participation Agreement and Liability Release
Consent and Release:
I acknowledge that soccer is a contact sport, which involves the possible risk of injury. I consent to my
child’s participation in F.C. Mirage (FCM) soccer program and summer camp. I, individually, and on behalf of my
child, do hereby release and forever discharge FCM, its shareholders, officers, members, coaches, directors, agents
and representatives from any and all liability of whatever nature relating to or in any matter arising out of my child’s
participation in any and all programs offered by the FCM. I agree to hold the FCM harmless and indemnify it for
any damages, which may be sustained in connection with our association or with participation in the FCM soccer
program. I understand that personal injuries can occur before, during, and after soccer games, practices or camps by
reason of field preparation and conditions, equipment conditions, and contact with participants, FCM personnel and
spectators. This release shall apply to any personal injury or other loss whether or not reasonably anticipated,
expected, or contemplated at this time. This release is indemnification shall be binding upon my personal
representatives, heirs and assigns.
__________________________________________________________________
Parent or Guardian Signature
Date