2017 WILDCAT YOUTH FOOTBALL CAMP

2017 WILDCAT YOUTH FOOTBALL CAMP (Rising 3rd-8th Grades) DATE: JUNE 12-JUNE 15 TIME: 5:30pm-7:00pm DAILY INSTRUCTION: CURRENT ECHHS COACHING STAFF, PLAYERS & FORMER COLLEGIATE PLAYERS PLACE: EAST CHAPEL HILL HIGH SCHOOL FOOTBALL PRACTICE FIELD COST: $100 T-SHIRT INCLUDED (May Checks Payable to East Chapel Hill Football) *Mail-in Registration Address East Chapel Hill High School Attn: Ryan Johnson 500 Weaver Dairy Road Chapel Hill, NC 27514 I, the undersigned parent or guardians do hereby grant permission for my child to attend WILDCAT YOUTH FOOTBALL CAMP. I have completed the Student Medical Release Form below with the necessary information. In the case that my child should sustain injury or illness during the time of the camp, I hereby authorize medical treatment deemed necessary and as prescribed by a licensed physician. I further acknowledge that I will be responsible for any medical expenses incurred on behalf of my child for physical injury or illness that he/she may sustain during the camp. I also agree to release and hold harmless the Chapel Hill-Carrboro City School, its officers, trustees, agents, and employees, including but not limited to all persons employed or hired to help with the camp from any liability for personal injury or property damage arising out of the participant’s participation I have read the medical release and rules and agree to the adherence thereof.

Participant Signature Date

Parent/Guardian Signature Date

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Student Medical Release Form Student’s Name

School Attending

Birth Date

T-Shirt Size

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2017-2018 School Year Grade Level

Parent/Guardian Name

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Insurance Company Policy #

Contact Person(s)/Relation/ Phone Numbers

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