Mod-B Football

Mini Camp

June 13-16 @ Spry

3:30-5:30

No Cost

Modified Team Camp*

When: July 25-28 (6:00-8:30PM)

Where: Schroeder High School

Cost: $80

*Modified Coaches will arrange for equipment pick up for camp

Schroeder Football Summer Camp Registration Form

*Please check the camp(s) you are registering for

_______Schroeder Warriors Team Camp:$95 (JV/Varsity): August 1-4 (5:30-8:30)

_______ Schroeder Modified Team Camp: $80 (7^th, 8^th, 9^th graders): July 25-28 (5:30-8:30)

*Make checks payable to Webster Warriors Football Booster- Return to Coach Watkins

Name:		Grade in 2016:
Address:		Zip:
Phone:		Height:
School:		Weight:
Grade:		Age:
Offensive Position:		Defensive Position:

MEDICAL PERMISSION AND LIABILITY WAIVER

Parent or Guardian Consent:

I hereby give my consent for:

__________________________________  to participate in all activities of the SCHROEDER  FOOTBALL CAMP.  I understand that participating in football and other camp activities involves a risk of injury or other harm.  All risks are being assumed knowingly and voluntarily.  I will not hold Kali Watkins and the Webster Central School District, its employees and agents responsible for any injury or other harm those results from participation in the football camp.  I hereby acknowledge that I have the appropriate medical/accident & dental insurance coverage for my participating child/children.  My son is in good health and he has no physical condition that would prevent him from participating in the football camp. 

*I authorize the trainer to administer needed first-aid and seek medical attention in case of an emergency.

Signature of Parent or Guardian: __________________________________________________

Health Insurance Company/Provider: ______________________________________________

Policy Number:________________________________________________________________

*Should there be an emergency and we cannot reach you, whom should we contact?

NAME:____________________________________________

RELATIONSHIP:_____________________________________

PHONE:___________________________________________