Choctaw Nation of Oklahoma
Choctaw Nation of Oklahoma
FOOTBALL CAMP ‘11 DEADLINE FOR APPLICATION IS APRIL 1, 2011
ALL DISTRICTS PAUL LAIRD STADIUM SOUTHEASTERN OKLAHOMA STATE UNIVERSITY DURANT, OKLAHOMA July 5 - 6, 2011 9:00am - 4:00pm
FOOTBALL CAMP BUS SCHEDULE CAMP JULY 5 & 6
Departing Returning
Departing Returning
BUS 5
BUS 1
Talihina Field Office
6:00 A.M.
7:00 P.M.
Poteau Field Office
4:45 A.M.
8:15 P.M.
Spiro Field Office
5:15 A.M.
7:45 P.M.
Stigler Field Office
6:00 A.M.
7:00 P.M.
Antlers Field Office
7:20 A.M.
5:25 P.M.
Soper High School
7:40 A.M.
5:05 P.M.
Boswell High School
7:50 A.M.
4:55 P.M.
BUS 6
Bennington High School 8:00 A.M.
4:45 P.M.
Rock Creek High School
4:35 P.M.
8:10 A.M.
BUS 2 Idabel Field Office
6:30 A.M.
6:15 P.M.
BUS 7
Valliant (Doc Store)
6:55 A.M.
5:50 P.M.
McAlester Field Office
6:35 A.M.
6:25 P.M.
Fort Towson High School 7:15 A.M.
5:30 P.M.
Coalgate Field Office
7:35 A.M.
5:25 P.M.
Hugo Community Center 7:30 A.M.
5:15 P.M.
6:20 A.M.
6:40 P.M.
VAN Wilburton Field Office
BUS 3 Broken Bow Field Office
6:00 A.M.
6:45 P.M.
Wright City Field Office
6:30 A.M.
6:15 P.M.
Atoka Travel Plaza
7:50 A.M.
4:55 P.M.
Caddo Dairy Queen
8:10 A.M.
4:35 P.M.
BUS 4
All Times Are Approximate Times. Please have the camper at the pick-up location at least 15 minutes prior to departure time. Also, please arrive 15 minutes prior to the returning time to pick-up the camper.
Choctaw Nation of Oklahoma
FOOTBALL CAMP ‘11 Deadline: April 1, 2011 INSTRUCTIONS:
Complete Application and Sign. Mail to: Choctaw Summer Camp • c/o Kevin Gwin / Cyndi Houser • PO Box 1210 • Durant, OK 74701 • 1-800-522-6170
Name: Phone: Address: Age:
City: Date of Birth:
Male
/
State: Zip: Female
Circle T-Shirt Size: Youth (10 - 12) (14 - 16) ; Adult (Small) (Medium) (Large) (X-Large) (2X-Large) (3X-Large) Have you attended any of our camps? Do you have insurance?
Y
N
Y
N
List the camp & how many years:
List insurance information:
Emergency contact person & phone #: Medical Information:
CONSENT: I authorize a representative of the Choctaw Nation Staff, Camp Director, and Instructor to seek medical treatment for my child, if I am not present, while participating in this camp. In consideration of the sponsors and facility owner accepting this application, I hereby release and waiver all rights to any claim for damages and/or injury my child may suffer while participating in this camp. I understand and agree that medical or other services rendered to my child by the camp sponsors/facility owner is not an admission of liability or continued services.
Signature of Parent / Guardian
Date
CAMP LISTING ALL DISTRICTS WILL ATTEND THE SAME CAMP. Ages 8 - 18. Deadline: April 1, 2011
PAUL LAIRD STADIUM • SOSU • Durant, Oklahoma July 5 - 6, 2011 • 9:00am - 4:00pm Bus Rider: yes / no Pick-up Location:_____________________________________ See attached schedule
PLEASE NOTIFY CAMP STAFF IF CHILD WILL BE PICKED UP EARLY. ATTACH COPY OF CHOCTAW MEMBERSHIP AND CDIB
Office Info _________________________ _________________________
FOOTBALL CAMP ‘11 DEADLINE FOR APPLICATION IS APRIL 1, 2011
ALL DISTRICTS PAUL LAIRD STADIUM SOUTHEASTERN OKLAHOMA STATE UNIVERSITY DURANT, OKLAHOMA July 5 - 6, 2011 9:00am - 4:00pm
FOOTBALL CAMP BUS SCHEDULE CAMP JULY 5 & 6
Departing Returning
Departing Returning
BUS 5
BUS 1
Talihina Field Office
6:00 A.M.
7:00 P.M.
Poteau Field Office
4:45 A.M.
8:15 P.M.
Spiro Field Office
5:15 A.M.
7:45 P.M.
Stigler Field Office
6:00 A.M.
7:00 P.M.
Antlers Field Office
7:20 A.M.
5:25 P.M.
Soper High School
7:40 A.M.
5:05 P.M.
Boswell High School
7:50 A.M.
4:55 P.M.
BUS 6
Bennington High School 8:00 A.M.
4:45 P.M.
Rock Creek High School
4:35 P.M.
8:10 A.M.
BUS 2 Idabel Field Office
6:30 A.M.
6:15 P.M.
BUS 7
Valliant (Doc Store)
6:55 A.M.
5:50 P.M.
McAlester Field Office
6:35 A.M.
6:25 P.M.
Fort Towson High School 7:15 A.M.
5:30 P.M.
Coalgate Field Office
7:35 A.M.
5:25 P.M.
Hugo Community Center 7:30 A.M.
5:15 P.M.
6:20 A.M.
6:40 P.M.
VAN Wilburton Field Office
BUS 3 Broken Bow Field Office
6:00 A.M.
6:45 P.M.
Wright City Field Office
6:30 A.M.
6:15 P.M.
Atoka Travel Plaza
7:50 A.M.
4:55 P.M.
Caddo Dairy Queen
8:10 A.M.
4:35 P.M.
BUS 4
All Times Are Approximate Times. Please have the camper at the pick-up location at least 15 minutes prior to departure time. Also, please arrive 15 minutes prior to the returning time to pick-up the camper.
Choctaw Nation of Oklahoma
FOOTBALL CAMP ‘11 Deadline: April 1, 2011 INSTRUCTIONS:
Complete Application and Sign. Mail to: Choctaw Summer Camp • c/o Kevin Gwin / Cyndi Houser • PO Box 1210 • Durant, OK 74701 • 1-800-522-6170
Name: Phone: Address: Age:
City: Date of Birth:
Male
/
State: Zip: Female
Circle T-Shirt Size: Youth (10 - 12) (14 - 16) ; Adult (Small) (Medium) (Large) (X-Large) (2X-Large) (3X-Large) Have you attended any of our camps? Do you have insurance?
Y
N
Y
N
List the camp & how many years:
List insurance information:
Emergency contact person & phone #: Medical Information:
CONSENT: I authorize a representative of the Choctaw Nation Staff, Camp Director, and Instructor to seek medical treatment for my child, if I am not present, while participating in this camp. In consideration of the sponsors and facility owner accepting this application, I hereby release and waiver all rights to any claim for damages and/or injury my child may suffer while participating in this camp. I understand and agree that medical or other services rendered to my child by the camp sponsors/facility owner is not an admission of liability or continued services.
Signature of Parent / Guardian
Date
CAMP LISTING ALL DISTRICTS WILL ATTEND THE SAME CAMP. Ages 8 - 18. Deadline: April 1, 2011
PAUL LAIRD STADIUM • SOSU • Durant, Oklahoma July 5 - 6, 2011 • 9:00am - 4:00pm Bus Rider: yes / no Pick-up Location:_____________________________________ See attached schedule
PLEASE NOTIFY CAMP STAFF IF CHILD WILL BE PICKED UP EARLY. ATTACH COPY OF CHOCTAW MEMBERSHIP AND CDIB
Office Info _________________________ _________________________
