The Windy City Pride Soccer Club

Summer Camp 

Print out and send along with check made out to Windy City Pride and mail to 24330 Norwood Dr. Plainfield, IL 60585: 

Please return to the office by July 1st

$75 per week

Name:______________________________________________________________Team Name:______________

Address:________________________________________________________City: __________________________ State:______ Zip: ___________________ 

Home Phone:______________________Players Email: ___________________________________Parents Email_______________________________________

Mother's Name:________________________________________ Cell Phone: _____________________________

Father's Name: ________________________________________ Cell Phone: _____________________________

Emergency Contact: 

Name: ________________________ Phone: _______________________ Cell: ___________________________ 

I hereby give permission and certify that my child is in good health and able to participate in all Windy City Pride Club Activities. I release coaches, staff, and all others associated

with the Windy City Pride Soccer Club of all Liability for any injury or illness incurred by my child at the Windy City Pride Soccer Club Tryouts. In Case of an emergency, I give

permission for my child to be given emergency treatment at a local hospital. I further release coaches, staff, and all others associated with the Windy City Pride Soccer Club of

any illegal recruitment associated with my tryout, and that I have informed the team that I am currently registered with of my intentions/actions.

Parents Signature:_________________________________________________________________________________ Date:_____________________