Chatham University

Men’s Lacrosse Prospect Day

All fields marked with * are required

mm/dd/yyyy

Parent Information

Insurance Information


Chatham University requires that the parent/guardian have medical insurance coverage for their child. Furthermore, I understand that any camper who does not abide by the rules and regulations promulgated by the camp or Chatham University is subject to dismissal without reimbursement or recourse. Such action will be administered by the Camp Director only. Camper will not be permitted to leave the Chatham University campus without parental consent for any reason other than medical emergency until the completion of a camp session. Chatham University assumes no responsibility for injuries sustained while on school grounds.

*I have read and agree with the statement above

Emergency Contact Information

I authorize Chatham University or its authorized representatives to take whatever actions it my consider to be warranted under the circumstances regarding my child's health and safety. I fully release and discharge Chatham University and its authorized representatives from any and all liability, claims, costs, demands or suits for such circumstances or actions as may or may not be taken in connection therewith. If you cannot reach me or any person listed above, I further authorize Chatham University or its authorized representatives, at its discretion to place my child at my expense in a hospital for medical services and treatment. Except in the event that the actions of Chatham University or its representatives are grossly negligent.

* I have read and agree with the statement above