I wish to enroll my son/daughter in the 2012 Mark Mirabelli's Track & Field Clinic. I understand that neither Notre Dame, the director, nor anyone connected with the Mark Mirabelli Clinic will assume any responsibility for accidents, medical, dental, or other expenses incurred as the result of accidents sustained during or as a result of any course of instruction given the applicant by the clinic staff. I hereby authorize the guardian, coach, or director to act on my behalf according to his/her best judgment in any emergency requiring medical attention.

Signature of Parent ____________________________     School ____________________________

Applicant's Name _____________________________     Age ____     Male ____     Female ____

Street Address _____________________________      City _____________________________

State _________     Zip Code _________     Home Phone ___________________________

Event ______________________________________________   

Email Address ______________________________________________

•  Handouts covering session topics will be available
• Bring indoor shots, discus, and javelins.
• Lunch will be sold by the Notre Dame Track Team.
• All presentations are interactive. Participants are expected to wear comfortable workout gear.
• Door prizes will be raffled off between sessions.
• Due to unforeseen emergency, clinicians may change.
• The "Mark Mirabelli Throwing Series" will be on sale for a $5.00 discount.