central mass - League Athletics
Football Camp Registration Form
About the Directors
Please enroll our child _______________________________ who is in good health and able to participate in the physical activity of a vigorous athletic program. In consideration for enrollment, we and our child hereby release, discharge, and hold harmless St. Peter-Marian, Central Mass Youth Football Camp, and their trustees, faculty, administrators, employees, and agents, from any and all claims that we and he/she may have for any damages, losses, or injuries to person or property, or both, which may be sustained while participating in athletic or any other activities, whether caused by negligence or any other acts or omissions, while our child is at the Football Camp. We, the undersigned*, authorize the Football Camp staff or other representatives to act for us, and on behalf of our child, in any emergency requiring medical attention, according to the staff’s or representative’s reasonable judgment under the circumstances. We also agree to be solely responsible for any and all medical and/or dental expenses incurred by our child.
Tom Henrickson is the current Head Football Coach of St. Peter-Marian High School. Prior to his appointment as Head Coach in 2009, the Guardian program did not have a winning season in over 5 years. Over the past 4 years, Coach Henrickson has guided the St. PeterMarian football team to a 26 – 18 record, playing a very tough Division 1 schedule. Previously, Coach Henrickson was a member of the coaching staff of two Super Bowl Championship teams - South High School (2007) and Shrewsbury High School (2000).
_________________________________________________ Signature of parent 1 or guardian 1
_________________________________________________ Signature of parent 2 or guardian 2
_________________________________________________ Child’s Name (print)
_________________________________________________ Address
_________________________________________________ City
State
ZIP Code
_________________________________________________ Home Phone
Cell Phone
Coach Henrickson’s success on the grid iron began well before he started his coaching career. As a student, Tom was one of the most talented football players in Central Massachusetts. He turned down a Division 1 scholarship from University of Maine to stay closer to home and help Worcester State College win a National Championship in 1980. During his tenure at Worcester State College, he was named All-Conference all 4 years and named All-American his junior and senior years. Scott Ladner is a founder and current president of Shrewsbury American Youth Football & Cheer Organization (SAYFCO), an executive board member for the Central Mass Football and Cheer Conference of American Youth Football (AYF) and a high school football coach at St. Mark’s School in Southborough, MA.
_________________________________________________ Email
_________________________________________________ Grade (in fall 2013) Positions (circle):
School Offense:
Line
TE
WR
RB
QB
Defense:
Line
MLB
OLB
DB
Sp. Teams:
Punt
P.Kick
Snap
Hold
Return
_________________________________________________ Person to call in case of emergency
Phone number
_________________________________________________ Medical Insurance Provider & policy number Shirt Size (circle one):
YM
YL
AS
AM
AL
AXL
*Both parents should sign unless deceased, legally separated or divorced.
AXXL
Since its inception in 2009 and under the leadership of Coach Ladner, SAYFCO has sent 9 teams to Central Mass Super Bowls, with 5 winning the Central Mass championships and 3 advancing to earn state titles. Coach Ladner was also on the coaching staff for an 8th Grade All-Star Team which finished 3rd in the county at the AYF National Championships in Florida. Coach Ladner’s success is not defined solely by wins and losses. He takes great pride in the hard work and sportsmanship demonstrated by his players. He is especially proud that, during his tenure at St. Mark’s, the football program has received two Sportsmanshipof-the-Year Awards (2008, 2012) from the Independent School League (ISL).
CENTRAL MASS
Camp July 15-July 18, 2013 5:30pm-7:30pm St. Peter-Marian High School 781 Grove Street Worcester, MA
Camp Philosophy
Notes to Parents
Central Mass Youth Football Camp has a veteran staff of knowledgeable high school and youth football coaches. The goal of the camp is to improve on the fundamentals of each position, working on technique and to learn something new about the game. We reinforce both the physical and mental aspects of the sport. Each year your child move up a level, football becomes more complex. We teach what to expect at the next level and help get your child prepare for it.
Details
First Day Check-In
Campers are divided into groups by age, size and playing level. An EMT or athletic trainer will be on site during all camp sessions. Bring a current Physician’s Medical Form to provide evidence of a physical exam within the past 12 months. The clinic will run rain or shine.
th
What:
Youth Football Camp
Who:
Boys and Girls entering grades 4-8
Registration is held Monday, July 15 from 4:30pm to 5:15pm. Note: Please bring a Physician’s Medical Form to registration.
When:
July 15-July 18, 2013, 5:30pm-7:30pm
Location
Where: St Peter-Marian High School 781 Grove St, Worcester, MA
Cost:
$150 (due in-full with registration) The fee covers supervised coaching instruction, use of SPM facilities, and a CMYFC tee-shirt.
What to bring A Physician’s Medical Form on the first day. A helmet and shoulder pads are required. (If you do not own your own equipment and cannot borrow equipment from your youth football program, they can be rented for $25. Contact us st by July 1 to reserve your equipment. Also bring a mouth guard, shorts, football jersey, and football cleats.
Contact Information For questions, contact Coach Scott Ladner at [email protected] or Coach Tom Henrickson at [email protected].
St Peter-Marian High School is located at 781 Grove Street in Worcester.
Detach registration form and mail to:
Central Mass Youth Football Camp P. O. Box 160 Shrewsbury, MA 0154 (Check made payable to Central Mass Youth Football Camp)
About the Directors
Please enroll our child _______________________________ who is in good health and able to participate in the physical activity of a vigorous athletic program. In consideration for enrollment, we and our child hereby release, discharge, and hold harmless St. Peter-Marian, Central Mass Youth Football Camp, and their trustees, faculty, administrators, employees, and agents, from any and all claims that we and he/she may have for any damages, losses, or injuries to person or property, or both, which may be sustained while participating in athletic or any other activities, whether caused by negligence or any other acts or omissions, while our child is at the Football Camp. We, the undersigned*, authorize the Football Camp staff or other representatives to act for us, and on behalf of our child, in any emergency requiring medical attention, according to the staff’s or representative’s reasonable judgment under the circumstances. We also agree to be solely responsible for any and all medical and/or dental expenses incurred by our child.
Tom Henrickson is the current Head Football Coach of St. Peter-Marian High School. Prior to his appointment as Head Coach in 2009, the Guardian program did not have a winning season in over 5 years. Over the past 4 years, Coach Henrickson has guided the St. PeterMarian football team to a 26 – 18 record, playing a very tough Division 1 schedule. Previously, Coach Henrickson was a member of the coaching staff of two Super Bowl Championship teams - South High School (2007) and Shrewsbury High School (2000).
_________________________________________________ Signature of parent 1 or guardian 1
_________________________________________________ Signature of parent 2 or guardian 2
_________________________________________________ Child’s Name (print)
_________________________________________________ Address
_________________________________________________ City
State
ZIP Code
_________________________________________________ Home Phone
Cell Phone
Coach Henrickson’s success on the grid iron began well before he started his coaching career. As a student, Tom was one of the most talented football players in Central Massachusetts. He turned down a Division 1 scholarship from University of Maine to stay closer to home and help Worcester State College win a National Championship in 1980. During his tenure at Worcester State College, he was named All-Conference all 4 years and named All-American his junior and senior years. Scott Ladner is a founder and current president of Shrewsbury American Youth Football & Cheer Organization (SAYFCO), an executive board member for the Central Mass Football and Cheer Conference of American Youth Football (AYF) and a high school football coach at St. Mark’s School in Southborough, MA.
_________________________________________________ Email
_________________________________________________ Grade (in fall 2013) Positions (circle):
School Offense:
Line
TE
WR
RB
QB
Defense:
Line
MLB
OLB
DB
Sp. Teams:
Punt
P.Kick
Snap
Hold
Return
_________________________________________________ Person to call in case of emergency
Phone number
_________________________________________________ Medical Insurance Provider & policy number Shirt Size (circle one):
YM
YL
AS
AM
AL
AXL
*Both parents should sign unless deceased, legally separated or divorced.
AXXL
Since its inception in 2009 and under the leadership of Coach Ladner, SAYFCO has sent 9 teams to Central Mass Super Bowls, with 5 winning the Central Mass championships and 3 advancing to earn state titles. Coach Ladner was also on the coaching staff for an 8th Grade All-Star Team which finished 3rd in the county at the AYF National Championships in Florida. Coach Ladner’s success is not defined solely by wins and losses. He takes great pride in the hard work and sportsmanship demonstrated by his players. He is especially proud that, during his tenure at St. Mark’s, the football program has received two Sportsmanshipof-the-Year Awards (2008, 2012) from the Independent School League (ISL).
CENTRAL MASS
Camp July 15-July 18, 2013 5:30pm-7:30pm St. Peter-Marian High School 781 Grove Street Worcester, MA
Camp Philosophy
Notes to Parents
Central Mass Youth Football Camp has a veteran staff of knowledgeable high school and youth football coaches. The goal of the camp is to improve on the fundamentals of each position, working on technique and to learn something new about the game. We reinforce both the physical and mental aspects of the sport. Each year your child move up a level, football becomes more complex. We teach what to expect at the next level and help get your child prepare for it.
Details
First Day Check-In
Campers are divided into groups by age, size and playing level. An EMT or athletic trainer will be on site during all camp sessions. Bring a current Physician’s Medical Form to provide evidence of a physical exam within the past 12 months. The clinic will run rain or shine.
th
What:
Youth Football Camp
Who:
Boys and Girls entering grades 4-8
Registration is held Monday, July 15 from 4:30pm to 5:15pm. Note: Please bring a Physician’s Medical Form to registration.
When:
July 15-July 18, 2013, 5:30pm-7:30pm
Location
Where: St Peter-Marian High School 781 Grove St, Worcester, MA
Cost:
$150 (due in-full with registration) The fee covers supervised coaching instruction, use of SPM facilities, and a CMYFC tee-shirt.
What to bring A Physician’s Medical Form on the first day. A helmet and shoulder pads are required. (If you do not own your own equipment and cannot borrow equipment from your youth football program, they can be rented for $25. Contact us st by July 1 to reserve your equipment. Also bring a mouth guard, shorts, football jersey, and football cleats.
Contact Information For questions, contact Coach Scott Ladner at [email protected] or Coach Tom Henrickson at [email protected].
St Peter-Marian High School is located at 781 Grove Street in Worcester.
Detach registration form and mail to:
Central Mass Youth Football Camp P. O. Box 160 Shrewsbury, MA 0154 (Check made payable to Central Mass Youth Football Camp)
