La Roche Women's Soccer ID Camp

Athlete Information

Athlete's Name

First NameLast Name

Phone Number

Preferred Position

Midfield, Defender, Goalkeeper, Forward

Does the athlete have any allergies, chronic illness, or medical conditions? If yes, please describe.

Is the athlete prescribed an inhaler? If yes, please explain any instructions.

Informed Consent and Acknowledgement

I hereby provide my consent for my child's participation in all activities organized by the soccer camp during the chosen camp session. By accepting my child's participation, I acknowledge and accept all the potential risks and hazards associated with these activities. I release, exempt, and indemnify the soccer camp and all its officials, representatives, and agents from any responsibility for injuries that may occur to my child during their travel to, engagement in, or return from the camp sessions.

If my child sustains an injury, I waive any claims against the soccer camp, including its coaches, affiliates, fellow participants, supporting organizations, advertisers, and, if applicable, the owners and landlords of the premises where the event is held. Engaging in sports activities, including soccer, inherently carries a risk of injury, which may include but is not limited to fractures, paralysis, or even fatality.

Medical Release and Authorization

As the legal guardian of the youth athlete listed, I hereby grant permission for qualified and licensed medical professionals to diagnose and administer treatment in the event of a medical emergency. This authorization is applicable when, in the medical professional's judgment, immediate attention is necessary to prevent further harm to the minor child's life, physical appearance, physical functionality, or to alleviate undue pain, suffering, or discomfort should there be a delay in treatment.

I hereby give consent to the attending physician to undertake any necessary medical or minor surgical procedures, conduct X-ray examinations, and administer immunizations to the youth athlete named. In cases of a serious illness, the requirement for major surgery, or significant accidental injury, I am aware that the attending physician will make every reasonable effort to contact me as swiftly as possible before proceeding with treatment. This authorization is granted after a reasonable attempt has been made to reach me.

I also authorize the affiliated individuals, including Directors, Coaches, and Team Parents, to provide essential emergency treatment before the child is admitted to a medical facility.

This consent is valid during the dates and for the duration of the registered season. I willingly provide this authorization to ensure prompt medical treatment under emergency circumstances, safeguarding the life and well-being of the named minor child when I am not present.

La Roche University Kerr Sport and Fitness Center

The Coaching Staff would like to invite you to attend our 2026 & 2027 recruiting classes ID Camp.

Itinerary:

10:30 Am Arrive at Kerr Fitness Center and Register.

$50 due at registration the morning of the Camp cash or check

(Money covers instruction, 2 meals and a tee shirt)

11:30 – Brunch

Noon – Admissions office talk and tour

1:00 - Practice Session with LRU Women’s coaching staff

This will be 4 – 20-minute sessions with water breaks between each.

2:30 Break - Information will be shared about the Women’s Soccer Program and the School

Coaches and Players will be available for questions

3:00 - Return to the field for small-sided games.

5:00 End session.

A meal will be provided at the end of the games.