Soccer Camp June 24th
Soccer Camp June 24th – June 27th Venue: Veeck Park, 701 E. Chicago Avenue, Hinsdale What you need to know: Camp Instructor: Tom Statham assisted by David Rout. A quick recap on Tom’s background: Tom is a professional soccer coach in England; he and David have been running soccer camps together for many years now. Tom’s credentials speak for themselves: he is one of the most senior Youth Team coaches at Manchester United, as well as Head Coach to one of England’s top private schools. Prior to coaching, Tom signed as a professional player for Middlesborough after finishing his teaching degree. 2 hour sessions* Monday through Thursday. Grades are determined by academic year 2013/14. Times: 8:00am-10:00am Grades 2nd-4th 10:00am-12:00pm Grades 5th & 6th 12:15pm-2:15pm Grades 7th & 8th 6:15pm – 8:15pm High School (Tues & Thurs Only) Open to Celtics and non-Celtics players, girls and boys. $150 per player (2nd-8th Grades)-and discounted to $130 per player for families with multiple participants. Please make checks payable to ‘Celtics.’ * High School players we have avoided the LTHS camp; player fee is $75.00. If you have any questions please contact David Rout at 773-499-9261 or [email protected] . We will also be running a Junior Celtics camp for U5-U7 during the same week (details and separate waiver are on page 3). For both camps we will circulate a list of participants a few days before to assist with carpooling options. Veeck Park is located just west of Spring Rock Park / I294 along 47th Street in Hinsdale.
To confirm that your daughter/son will participate, please complete the attached waiver on page 2 and, together with your check, send it to 110 S. Park, La Grange, IL 60525.
SOCCER CAMP June 24th- June 27th 2013 REGISTRATION WAIVER AND RELEASE OF ALL CLAIMS PLEASE READ THIS FORM CAREFULLY. BY SIGNING IT FOR YOUR MINOR/CHILD, YOU WILL BE RELEASING ALL CLAIMS FOR INJURIES THAT MIGHT BE SUSTAINED IN CONNECTION WITH THIS ACTIVITY. Date of Soccer Camp:
June 24th-June 27th
Times: 8:00am-10:00am 12:15pm-2:15pm
Grades 2 -4 Grades 7th & 8th
nd
Location: Veeck Park, 701 S. Chicago Ave, Hinsdale,IL
th
10:00am-12:00pm 6:15pm – 8:15pm
th
th
Grades 5 & 6
High Sch. (Tues & Thurs)
Participant’s Name: ___________________________________Date of Birth: ______________________________________ Circle Grade (2013/14):
2nd
3rd
4th
5th
6th
7th
8th
High School
Home Phone: ________________________________Cell Phone of a Parent: ______________________________________
Street Address: ___________________________________________ City: ________________________________________ State and Zip: ______________________________ Emergency Contact Number(s):________________________________ Correspondence Email: _________________________________________________________________________________
This release is executed on:___________________2013, by____________________________________________________ (Parent or Legal Guardian (please print & sign)) To The Celtics Sports Foundation, LG Celtics, Statham Soccer Limited, The Village of La Grange, The Village of Hinsdale and The City of Countryside, IL. I being of lawful age, in consideration for my child being permitted to participate in this activity, do for them, myself, heirs, executors, administrators and assigns, hereby release and forever discharge The Celtics Sports Foundation, Statham Soccer Limited, The City of Countryside, The Village of La Grange, The Village of Hinsdale its trustees, officers, agents, employees, servants and officials of and from any and every claim, demand, action, or right of action of whatever kind of nature, either in law or in equity raising from or by reason of any bodily injury or personal injury known or unknown, death or property damage resulting or to result from any accident which may occur as a result of participation in this activity or any activities in connection with this activity whether by negligence or not. I further release the Celtics Sports Foundation, LG Celtics, Statham Soccer Limited, The City of Countryside, The Village of La Grange, The Village of Hinsdale and its trustees, employees, and agents from any claim whatsoever on account of first aid treatment or service rendered my child during participation in this activity. The release contains the entire agreement between parties hereto and the terms of this release are contractual and not a mere recital. I have carefully read the foregoing release and know the contents thereof and sign this release as my own free act. In witness whereof, I have executed this release the date and year first above written.
For: ____________________________________ (Participant’s Name)
____________________________________ (Parent’s Signature)
JUNIORS SOCCER CAMP June 24th- June 27th 2013 Date of Soccer Camp: June 24th-June 27th Cost:
Times: 8:00am-10:00am
Location: Veeck Park (47th west of I294)
$130 / player ($120 / player for families with multiple participants). Checks made payable to ‘Celtics’.
Please complete the waiver below and, together with your check, send it to 110 S. Park, La Grange, IL60525. REGISTRATION WAIVER AND RELEASE OF ALL CLAIMS PLEASE READ THIS FORM CAREFULLY. BY SIGNING IT FOR YOUR MINOR/CHILD, YOU WILL BE RELEASING ALL CLAIMS FOR INJURIES THAT MIGHT BE SUSTAINED IN CONNECTION WITH THIS ACTIVITY. Participant’s Name: ___________________________________Date of Birth: ___________________________________________ Circle Grade (2013/14):
Pre-K
K
1st
2nd
Home Phone: ________________________________Cell Phone of a Parent: __________________________________________ Street Address: ___________________________________________ City: ____________________________________________ State and Zip: ______________________________ Emergency Contact Number(s):____________________________________ Correspondence Email: _______________________________________________ This release is executed on:___________________2013, by________________________________________________________ [Parent or Legal Guardian (please print & sign)] To The Celtics Sports Foundation, LG Celtics, Village of La Grange, Village of Hinsdale and The City of Countryside, IL. I being of lawful age, in consideration for my child being permitted to participate in this activity, do for them, myself, heirs, executors, administrators and assigns, hereby release and forever discharge The Celtics Sports Foundation, LG Celtics, The City of Countryside, The Village of La Grange, The Village of Hinsdale its trustees, officers, agents, employees, servants and officials of and from any and every claim, demand, action, or right of action of whatever kind of nature, either in law or in equity raising from or by reason of any bodily injury or personal injury known or unknown, death or property damage resulting or to result from any accident which may occur as a result of participation in this activity or any activities in connection with this activity whether by negligence or not. I further release the Celtics Sports Foundation, LG Celtics, The City of Countryside, The Village of La Grange, The Village of Hinsdale and its trustees, employees, and agents from any claim whatsoever on account of first aid treatment or service rendered my child during participation in this activity. The release contains the entire agreement between parties hereto and the terms of this release are contractual and not a mere recital. I have carefully read the foregoing release and know the contents thereof and sign this release as my own free act. In witness whereof, I have executed this release the date and year first above written.
For: ____________________________________ (Participant’s Name)
____________________________________ (Parent’s Signature)
To confirm that your daughter/son will participate, please complete the attached waiver on page 2 and, together with your check, send it to 110 S. Park, La Grange, IL 60525.
SOCCER CAMP June 24th- June 27th 2013 REGISTRATION WAIVER AND RELEASE OF ALL CLAIMS PLEASE READ THIS FORM CAREFULLY. BY SIGNING IT FOR YOUR MINOR/CHILD, YOU WILL BE RELEASING ALL CLAIMS FOR INJURIES THAT MIGHT BE SUSTAINED IN CONNECTION WITH THIS ACTIVITY. Date of Soccer Camp:
June 24th-June 27th
Times: 8:00am-10:00am 12:15pm-2:15pm
Grades 2 -4 Grades 7th & 8th
nd
Location: Veeck Park, 701 S. Chicago Ave, Hinsdale,IL
th
10:00am-12:00pm 6:15pm – 8:15pm
th
th
Grades 5 & 6
High Sch. (Tues & Thurs)
Participant’s Name: ___________________________________Date of Birth: ______________________________________ Circle Grade (2013/14):
2nd
3rd
4th
5th
6th
7th
8th
High School
Home Phone: ________________________________Cell Phone of a Parent: ______________________________________
Street Address: ___________________________________________ City: ________________________________________ State and Zip: ______________________________ Emergency Contact Number(s):________________________________ Correspondence Email: _________________________________________________________________________________
This release is executed on:___________________2013, by____________________________________________________ (Parent or Legal Guardian (please print & sign)) To The Celtics Sports Foundation, LG Celtics, Statham Soccer Limited, The Village of La Grange, The Village of Hinsdale and The City of Countryside, IL. I being of lawful age, in consideration for my child being permitted to participate in this activity, do for them, myself, heirs, executors, administrators and assigns, hereby release and forever discharge The Celtics Sports Foundation, Statham Soccer Limited, The City of Countryside, The Village of La Grange, The Village of Hinsdale its trustees, officers, agents, employees, servants and officials of and from any and every claim, demand, action, or right of action of whatever kind of nature, either in law or in equity raising from or by reason of any bodily injury or personal injury known or unknown, death or property damage resulting or to result from any accident which may occur as a result of participation in this activity or any activities in connection with this activity whether by negligence or not. I further release the Celtics Sports Foundation, LG Celtics, Statham Soccer Limited, The City of Countryside, The Village of La Grange, The Village of Hinsdale and its trustees, employees, and agents from any claim whatsoever on account of first aid treatment or service rendered my child during participation in this activity. The release contains the entire agreement between parties hereto and the terms of this release are contractual and not a mere recital. I have carefully read the foregoing release and know the contents thereof and sign this release as my own free act. In witness whereof, I have executed this release the date and year first above written.
For: ____________________________________ (Participant’s Name)
____________________________________ (Parent’s Signature)
JUNIORS SOCCER CAMP June 24th- June 27th 2013 Date of Soccer Camp: June 24th-June 27th Cost:
Times: 8:00am-10:00am
Location: Veeck Park (47th west of I294)
$130 / player ($120 / player for families with multiple participants). Checks made payable to ‘Celtics’.
Please complete the waiver below and, together with your check, send it to 110 S. Park, La Grange, IL60525. REGISTRATION WAIVER AND RELEASE OF ALL CLAIMS PLEASE READ THIS FORM CAREFULLY. BY SIGNING IT FOR YOUR MINOR/CHILD, YOU WILL BE RELEASING ALL CLAIMS FOR INJURIES THAT MIGHT BE SUSTAINED IN CONNECTION WITH THIS ACTIVITY. Participant’s Name: ___________________________________Date of Birth: ___________________________________________ Circle Grade (2013/14):
Pre-K
K
1st
2nd
Home Phone: ________________________________Cell Phone of a Parent: __________________________________________ Street Address: ___________________________________________ City: ____________________________________________ State and Zip: ______________________________ Emergency Contact Number(s):____________________________________ Correspondence Email: _______________________________________________ This release is executed on:___________________2013, by________________________________________________________ [Parent or Legal Guardian (please print & sign)] To The Celtics Sports Foundation, LG Celtics, Village of La Grange, Village of Hinsdale and The City of Countryside, IL. I being of lawful age, in consideration for my child being permitted to participate in this activity, do for them, myself, heirs, executors, administrators and assigns, hereby release and forever discharge The Celtics Sports Foundation, LG Celtics, The City of Countryside, The Village of La Grange, The Village of Hinsdale its trustees, officers, agents, employees, servants and officials of and from any and every claim, demand, action, or right of action of whatever kind of nature, either in law or in equity raising from or by reason of any bodily injury or personal injury known or unknown, death or property damage resulting or to result from any accident which may occur as a result of participation in this activity or any activities in connection with this activity whether by negligence or not. I further release the Celtics Sports Foundation, LG Celtics, The City of Countryside, The Village of La Grange, The Village of Hinsdale and its trustees, employees, and agents from any claim whatsoever on account of first aid treatment or service rendered my child during participation in this activity. The release contains the entire agreement between parties hereto and the terms of this release are contractual and not a mere recital. I have carefully read the foregoing release and know the contents thereof and sign this release as my own free act. In witness whereof, I have executed this release the date and year first above written.
For: ____________________________________ (Participant’s Name)
____________________________________ (Parent’s Signature)
