ESAD European Soccer Clinics

Winter Clinic Schedule

Directions; Information; Registration; On-Line at www.FCNapoli.com/Clinic

Mail Check and mail registration below to: Esad Clinics, PO Box 494 Worc. MA 01613

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Athlete Name: ___________________________________   Age: ____    Phone: ____________________

Address: _____________________________________________________________________________

The above named soccer player has my permission to participate in the ESAD European Soccer Academy and / or Clinics. I further certify that him/her is capable of participating in a strenuous physical activity, to wit soccer. I also agree to hold harmless the F.C. Napoli soccer club, its staff, agents, the facility or anyone affiliated with ESAD European Soccer from any and all injuries which may be sustained by the player during his/her participating in the try out. In case of emergency, I understand every attempt will be made to care for the above named player.   I give my permission to the tending physician to render medical treatment to the participant, including (if necessary) hospitalization. Any expense arising from or illness is the responsibility of the person signing below.   Clinic registration is complete when payment is received.

Parent Signature: __________________________________________    Date: ____/____/____