Football Skills Speed Camp Registration
Last Name First Name
Adult T-shirt size: S M L XL XX 3X Fall 2011 Grade --> 7 or 8
Address City Zip
Name of Parent/Guardian
Phone email
Name of Parent/Guardian
Phone email
Release:
I/we, the undersigned, as parents/guardians of ask that he/she be admitted to the Speed Camp. In consideration of such admission, I agree to release, discharge, and hold harmless The Speed Camp, its officers, agents, and employees of and from all causes, liabilities, damages, claims, or demands whatsoever on account of any injury or accident involving my minor child arising out of attendance/participation at this camp or in the course of competition or activities held in connection with the camp. I/we recognize that participation in athletics and sporting activities involves inherent risk of injury. Further, I agree to assume responsibility for all medical costs arising from any injury incurred during or in connection with the camp.
Signature of Guardian Date
Signature of Guardian Date
Emergency Medical Authorization:
In the event reasonable attempts to contact me/us at the numbers provided on this sheet prove unsuccessful, I/we hereby give my consent for the administration of The Speed Camp to seek (1) the administration of any treatment deemed necessary by the doctor listed below, or another licensed physician if they are not available; and (2) the transfer of this student to the preferred hospital listed below or any other hospital that is reasonably accessible. This authorization is intended to expedite emergency medical care for injuries sustained by a camper during the camp and as such is valid only during the camp and time frames related to the camp.
Signature of Guardian Date
Signature of Guardian Date
Preferred Physician Phone
Preferred Hospital City
Please list any physical ailments or medical conditions that the camp staff should be aware of:
Payment and Registration Information
Please make payment in full amount of $75 to Football Skills Speed Camp.
Completed and signed camp registration and payment may be mailed to:
Attn: Robb Webb, Head Football Coach
Whittier Middle School
2000 W. Brooks
Norman, Oklahoma 73069
Football Skills Speed Camp
Mon 01 Aug – Fri 05 Aug 2010
4:00 - 6:00 PM @ Whittier Middle School
Cost: $ 75
* Camp fee includes 5 days instruction in speed and agility skills specific to the game of football and camp T-shirt.
* Camp is open to all students who will be in 7th or 8th grade in Fall 2011.
* Coaching staff will be made up of members of Whittier Middle School Football coaching staff, current and former middle and high school coaches.
* Areas of specific instruction include:
Running form and mechanics.
Strength training for speed.
Agility and quickness drills.
Reaction drills.
Campers should bring cleats, shorts, T-shirt, and a large water bottle. Also, campers should bring tennis shoes in case bad weather forces us indoors.
Please direct any questions to:
Coach Robb Webb Whittier Middle School: 366-5956
Cell: 514-1378