5 Star Soccer Camps!, Inc.
"Make Your Move to Improve."
For further details, please visit us online.
2014 Fall Foot Skills Kickoff Clinic Hinsdale - Sunday, August 17, 2014
Youth players are invited to come out for the 2014 Fall Foot Skills Kickoff Clinic designed to introduce and review first touch, technique and dribbling moves that can be utilized and developed throughout the fall season! Space is limited. All players should be prepared to bring a ball, bring plenty of water and have a ton of FUN!
Small groups / teams recommended & encouraged.
Sunday, August 17, 2014 (Robbins Park)
Session I (1:00pm-2:30pm) Grades K-2
Session II (2:30pm - 4:00pm) Grades 3-6
Fee: $30
First Name *
Your answer
Last Name *
Your answer
Age *
Please select the age of your son / daughter on the day of the clinic.
Date of Birth *
mm / dd / yyyy
Your answer
Camper M / F *
Address *
Your answer
City *
Your answer
State *
Zip *
Your answer
Parent / Guardian *
First and Last Name of the primary contact.
Your answer
Phone *
Please enter the best number to reach Parent / Guardian. 1-222-333-4444
Your answer
Email *
Please enter the best email to send a clinic confirmation.
Your answer
Small Groups / Teams *
If you are registering a team or small group that you would like to have trained together, please indicate this below, and send us the names of the group to be together in an email to: fivestarcamps@gmail.com. Thank you.
(A) Session I (1:00pm-2:30pm) Grades K-2
(B) Session II (2:30pm - 4:00pm) Grades 3-6
Session *
Please make your enrollment selection below. Please note Session I will be designed for grades K through 2. Session II is designed for grades 3 through 6.
Payment *
Please select your payment amount. Make checks payable to: 5 Star Soccer Camps!, Inc.
MAIL TO: 5 Star Soccer Camps!, Inc., PO BOX 9636, Naperville, Illinois 60567 Attn: Coach Michael Wiggins
Waiver & Release *
In consideration of being enrolled the current program offering, I acknowledge and agree that injury may occur, and hereby give permission and certify that my son / daughter is in good health and able to participate in all camp activities. I understand the risks and assume all responsibility that comes from participation. I, and on behalf of my heirs, assigns, personal next of kin, release and hold harmless all coaches, staff and all others associated with 5 Star Soccer Camps!, Inc. including officers, officials, agents, and/or employees, sponsoring agencies, sponsors advertisers and if applicable, owners and lessors of premises used for the event of any and all liability for any injury, disability, death, or illness incurred by my child at the soccer training program and/or camp activity. This includes any loss or damage to person or property, whether arising from the negligence of the releases or otherwise. I have looked over the facility for this event and acknowledge it as appropriate for the program, understanding that 5 Star Soccer Camps!, Inc. is not warranting the condition of the facility, or field space. I give 5 Star Soccer Camps!, Inc. permission to use without compensation, myself or my child’s image, likeness, or quotes in connection with any promotional materials including but not limited to: brochures, advertising or website publications. In case of emergency, I grant permission for my son / daughter to be given emergency treatment at a local hospital. I have read this waiver and release of liability and agree to its terms.
“Coach Wiggins teaches what I learned in the fundamentals, required at the professional level from a very early age while still having the amount of fun all kids should have.” Will Johnson, Portland (MLS), Canadian National Team

“Coach Wiggins was instrumental in my early development as a youth soccer player. His guidance helped me improve my soccer skills, along with the physical and mental aspects of the game. The early stages of player development are crucial, and Coach Wiggins has proven to be effective in guiding players to long and successful soccer careers.” Tim Regan – Former player, MLS; Assistant Coach Indy Eleven, NASL.
Further Questions?
Contact: Michael Wiggins, Director
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy