Please send this side of the page along with check payable to:
Maryville Women’s Soccer
650 Maryville University
St. Louis, MO 63141
2016 High School Sumer ID Camp
Player Name
Age
Address
City
Saturday, July 23, 2016
State
Zip
Email
Cell Phone
Ages: 14-18
Location: Maryville University Campus
What to Bring: Indoor and Outdoor soccer shoes.
Weather appropriate training attire.
Schedule: Daily schedule will be sent after registration.
School
Club Team
Position
Academic Interest
Please list any soccer accomplishments:
Current Grade____ _
T-Shirt Size__ ____
Saturday 7/23/16 9:00 A.M. till 4:00 P.M.
Cost: $85
Contact: Women's Head Coach EricDelabar
[email protected] or 314.529.9311
CAMP DESCRIPTION:
The focus of the camp is to allow serious
soccer players the opportunity to train in
a competitive environment. Players will
be under the direction of Women's head
coach Eric Delabar with assistant coaches
Lori Chalupny and Dave Thurmer.
WAIVER STATEMENT:
I hereby authorize the director of the sports camps and his or her
subordinates, to seek any medical and/or surgical treatment which is
reasonably thought to be necessary for the care of my child. The program
director is authorized to provide medical treatment to my child, and I shall
be fully responsible for honoring such costs. I also authorize the medical
facility to release all information needed to complete insurance claims. I
authorize insurance payment directly to the medical facility.
Parents and Guardians will be asked to acknowledge agreement to the above
waiver upon registering their child in a Maryville University Sports Camp.
Insurance Company
Policy Number
Card Number
The Saints currently compete at the
NCAA Division II level in the Great Lakes
Valley Conference. (GLVC)
Parent/Guardian Signature
Date