2015 Camp Registration

Complete the on-line form below to pre-register…

ALSO PRINT & 
BRING THIS SIGNED INFORMATION AND RELEASE FORM TO CAMP WITH YOU.

 

 

On-line Pre Registration Form

Name *
Age  
Shirt Size  
Address  *
Address2  
City   *
State   *
Zip   *
Telephone   *
Email Id *
   
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Your privacy is protected and info will not be shared.

Parent/Guardian Name ____________________________

Participant’s Full Name: _________Address____________

Telephone_______ Email________________________

Shirt Size _____  Football _____ Cheer Camp ________

 

Dr. Carthen, The Leaders of Tomorrow Initiative Inc. and the Coaching Staff will assume no liability for injury and/or damages for the above athletes’ participation. Due to the serious nature of football, the athletes participating, and their parents, are urged to consult their physician concerning the athlete’s fitness to participate.

Football camps participants present certain inherit risks and hazards, which the participating athlete is urged to consider and which the athlete and their parents assume all the risk. I hereby approve of my child participation, the above named athlete, in the "99 Reasons" Football Camp and consent to emergency medical treatment of the child on my behalf. To the best of my knowledge there are no physical or other conditions that will interfere with my child’s participation.

Parent or Guardian Signature: _________________
Insurance Provider: ___________
Policy Number: __________Date: ____________

 

 

 

CLICK HERE TO PRINT & 
BRING SIGNED INFO & 
RELEASE FORM TO CAMP