CPS SCORE! Summer Camp Student Registration
Parents, please fill out the form in its entirety. The CPS SCORE! Summer Camps will take place on Monday-Thursday and will start on July 8th and ends the week of August 3rd. Each week will consist of drills and instructions. During the final week of camp, there will be a field day to celebrate the 2017-18 school year of the CPS SCORE! Program.

Space is limited to 75 athletes per age group, on a first come-first serve basis at 4 different regional locations.

Note: Students can participate in a maximum of 1 camp over the course of the four 4-week summer programming. Please choose your sport and location option in order of preference, you will be placed in a clinic based on availability.

Registration deadline: Sunday, July 1st at 11:59 P.M.

Email address *
School Name *
Your answer
Student ID Number *
Your answer
Students First Name *
Your answer
Student's Last Name *
Your answer
Gender *
Birthdate *
MM
/
DD
/
YYYY
Grade Level *
Required
Current Age *
Your answer
Clinic Choice *
First Location Preference *
Second Location Preference *
Third Location Preference *
Last Physical Exam Date *
MM
/
DD
/
YYYY
Medically Cleared to Play? *
Please indicate any medical conditions or allergies staff should be aware of during program activities:
Your answer
Parent/Guardian Contact Name *
Your answer
Parent Guardian Relationship to Student *
Your answer
Parent Guardian Phone Number *
Your answer
Secondary Contact Name
Your answer
Secondary Contact Relationship to Student
Your answer
Secondary Contact Phone Number
Your answer
I understand and accept all risks inherent in participating in a CPS SCORE! Summer Camp. I release, relieve, discharge, and hold harmless the Board of Education of the City of Chicago (Board), its officers, Board members, employees, agents and representatives, from any and all liability or claim of liability, whether for personal injury, property damage, or otherwise, arising out of or in connection with the CPS SCORE! Summer Camp, and that I agree to be fully bound hereby *
I authorize program personnel, including Board employees, volunteers, or chaperones to act for me in any emergency, accident or illness involving my child. I further agree that the Board and its employees, volunteers, chaperones, program personnel, are released from any and all liability or claims for taking such action. *
I assume full responsibility during my child’s commute to and from the camp location. *
I confirm that my child meets CPS’ Physical Examination requirement and has proof of a current Physical Examination on file at the school. I affirm that my child has no chronic medical, physical or mental condition or disability which has not been stated in the medical certificate or which could make participation in the CPS SCORE! Summer Camp inadvisable. *
Submit
Never submit passwords through Google Forms.
This form was created inside of Chicago Public Schools. Report Abuse - Terms of Service - Additional Terms