SNOW COLLEGE FOOTBALL CAMP
SNOW COLLEGE FOOTBALL CAMP 2017 TEAM CAMP JUNE 25-28 or JULY 16-19 (circle one)
Registration Information SCHOOL _____________________________________________
YEAR IN SCHOOL—FALL 2017 _______________________
NAME ________________________________________________
ADDRESS ___________________________________________
CITY _______________________ STATE______ ZIP ________
DOB ______________ PLACE OF BIRTH _______________
HOME PHONE _____________________CELL PHONE______________________ EMAIL _________________________________ ARE YOU A U.S. CITIZEN?
YES /
NO
HOW LONG HAVE YOU LIVED IN UTAH _______________________
CAMPER SIGNATURE ___________________________________________________
DATE _______________________
PARENT/GUARDIAN SIGNATURE_________________________________________
DATE _______________________
PARENT/GUARDIAN NAME (Please Print)_________________________________________________________ In accordance with the provisions of the Family Education Rights and Privacy Act of 1974 and the confidentiality of Records Policy of the College, students have the right to place restrictions on their directory information. To place a restriction of hold on your records, you must make a request in writing with the registrar’s office.
Ethnic Origin (required for Federal Reporting) American Indian or Alaskan Native Asian Other ____________________________
Please Circle One:
Native Hawaiian or Pacific Islander
Black or African American
Hispanic or Latino
White, Non-Hispanic
Camp Cost Information
Camp Format
Cost: contact coach for pricing details. (Pricing will vary based on number of campers per school.)
Structure The Snow College Badger Football Camp is designed to improve teams and individuals alike. Each participating team will compete against other teams in a variety of drills such as scrimmages, 7 on 7’s, and 1 on 1’s.
Dear Coaches and Athletes, We are proud to have you and your team be a part of the 2017 Snow Badger Football Team Camps. Snow College has earned a reputation of being one of the finest Junior College programs in the United States. Snow is consistently ranked nationally, including 17 conference titles and a National Championship in 1985. Snow has produced many Division I players including Drew Robinson (Arizona - TE), Mikel Overgard (NC State - OL), Al Lapuaho (Utah St. - DL), Mazi Ogbonna and DeJay Lester (Wyoming - WR), Preston Hadley (BYU - DB) and Star Lotulelei and James Aiono (Utah DL). As well as current NFL players including, Matt Asiata (Minn. Vikings - RB), Brett Keisel (Pittsburgh Steelers - DL), Steven Paea (Wash. Redskins - DL). Our goal is to help the athlete become a better player and person through healthy competition against a number of Utah’s best High School programs. Badger Football campers will learn to play the Badger Way: Pride, Discipline, Toughness and Team. Campers will have an experience that they will remember for the rest of their lives as they develop lifelong relationships. We look forward to having you with us! GO BADGERS! Go Badgers!
Payments are to be made to the High School you are currently attending prior to camp. The High School will make one check to Snow College Football. Please direct questions to: Andrew Mitchell, Camp Director.: Phone: 435.283.7656 E-Mail: [email protected]
The Snow College coaching staff will be available to all campers during practice sessions to provide individual coaching. The staff will also be available throughout the day to meet with coaches to simply talk football. Our staff is available to help in any way. Housing All campers and coaches will stay at one of the following off-campus apartment complexes: Snow Garden Apartments or Park Place Apartments. The apartments are fully furnished with Air Conditioning, beds, couches, kitchen, refrigerator, oven, cabinet space, and multiple bathrooms. What to Bring ___ Payment ___ All Football Equipment ___ Medical/Insurance Form ___ Bed Linens (Pillow, Blankets, etc.) ___ Copy of Insurance Card ___ Bathroom Items (Soap,Towels, etc.) ___ Alarm Clock *All players must have Insurance to Participate in Camp* Check-In Information Campers will check in on Sunday evening June 25th or July 16th from 4PM6PM at Badger Stadium. The first meal provided will be Monday’s breakfast. Check-Out Information Camp will conclude Wed, June 28th/July 19th at NOON, at Badger Stadium, following closing remarks by Head Coach Paul Peterson. (No lunch will be served on the final day.) Emergency Telephone Numbers For parents, please acquire cell numbers for your campers coaches. Snow College Main Number: Snow College Training Room: Snow College Football Fax:
435.283.7000 435.283.7022 435.283.7031
Snow College FOOTBALL CAMPS Medical/Insurance Release form Name of Camper _______________________________
High School ________________________________________
Address _______________________________________
City ________________________ State _____
DOB ____________
Insurance Policy Holder Name ________________________
Phone _____________________
*MUST HAVE COPY OF INSURANCE CARD!* Camp Attending (circle one)
Zip _______
Insurance Policy Number _____________________________
Walk-On Tryout Team Camp Individual Camp RELEASE AND WAIVER OF CLAIMS
Youth Camp
In consideration of my child’s/dependent’s participation in the “Snow College Football Camps,” I do hereby, for myself, my child/dependent, my heirs and executors, waive, release and forever discharge all rights and claims for damages and/or injuries for which I or my child/dependent, against “Snow College Football Camps”, employees of Snow College and its agents for any and all injuries and/or damages which may be suffered by my child/dependent in connection with my child’s/dependent’s participation. Parent/Participant Initial ______
PERMISSION FOR MEDICAL ATTENTION The law requires that parental permission be obtained for operative procedures on minors. The parents/guardians need to sign the following consent form so that such procedures may be promptly carried out, and so that no unnecessary delays will occur with operative procedures. However, no operation will be performed, except emergency, without the parents/guardians being contacted and fully informed. I as a parent or legal guardian of (name of camp participant) ______________________, have actual knowledge and appreciation of the particulars of the camp including those risks involved in participation in football camp and hereby voluntarily consent to said minors participation and assume the risks arising there from. With my signature I give my permission for my son/daughter to receive emergency medical procedures deemed necessary. Parent/Participant Initial ______
MEDICAL HISTORY
YES A.
Please explain any
Birth deformities (one kidney, etc.)
B.
Medical Conditions currently under treatment
C.
Pre-Existing injury currently under treatment
D.
Fractures or other disability type injuries
E.
Allergy (drugs, food, asthma, etc.)
F.
Mental disorder
G.
Known past illness of more than one weeks duration
H.
Contact Lens or Glasses
I.
NO
questions answered “YES”
Other condition not listed above
_________________________________________________________________________________________________ _________________________________________________________________________________________________ I hereby state the “Snow College Football Camp” is not responsible for any pre-existing injury or illness of the above camper.
CONCUSSION POLICY If a concussion is sustained during camp, the Snow College training staff will follow the UHSAA Concussion Return to Play policy.
INSURANCE RELEASE “Snow College Football Camps” does not carry insurance for injuries, illnesses, etc… sustained during football camp. Campers participate at their own risk. I hereby authorize my son/daughter to participate in the “Snow College Football Camps” under the above medical release/insurance conditions.
________________________________________________
____________________________________________
Participant Name (Please Print)
Participant Signature
___________________________________________
_________________________________________
Parent/Guardian Name (Please Print)
Parent/Guardian Signature
Date Date
Registration Information SCHOOL _____________________________________________
YEAR IN SCHOOL—FALL 2017 _______________________
NAME ________________________________________________
ADDRESS ___________________________________________
CITY _______________________ STATE______ ZIP ________
DOB ______________ PLACE OF BIRTH _______________
HOME PHONE _____________________CELL PHONE______________________ EMAIL _________________________________ ARE YOU A U.S. CITIZEN?
YES /
NO
HOW LONG HAVE YOU LIVED IN UTAH _______________________
CAMPER SIGNATURE ___________________________________________________
DATE _______________________
PARENT/GUARDIAN SIGNATURE_________________________________________
DATE _______________________
PARENT/GUARDIAN NAME (Please Print)_________________________________________________________ In accordance with the provisions of the Family Education Rights and Privacy Act of 1974 and the confidentiality of Records Policy of the College, students have the right to place restrictions on their directory information. To place a restriction of hold on your records, you must make a request in writing with the registrar’s office.
Ethnic Origin (required for Federal Reporting) American Indian or Alaskan Native Asian Other ____________________________
Please Circle One:
Native Hawaiian or Pacific Islander
Black or African American
Hispanic or Latino
White, Non-Hispanic
Camp Cost Information
Camp Format
Cost: contact coach for pricing details. (Pricing will vary based on number of campers per school.)
Structure The Snow College Badger Football Camp is designed to improve teams and individuals alike. Each participating team will compete against other teams in a variety of drills such as scrimmages, 7 on 7’s, and 1 on 1’s.
Dear Coaches and Athletes, We are proud to have you and your team be a part of the 2017 Snow Badger Football Team Camps. Snow College has earned a reputation of being one of the finest Junior College programs in the United States. Snow is consistently ranked nationally, including 17 conference titles and a National Championship in 1985. Snow has produced many Division I players including Drew Robinson (Arizona - TE), Mikel Overgard (NC State - OL), Al Lapuaho (Utah St. - DL), Mazi Ogbonna and DeJay Lester (Wyoming - WR), Preston Hadley (BYU - DB) and Star Lotulelei and James Aiono (Utah DL). As well as current NFL players including, Matt Asiata (Minn. Vikings - RB), Brett Keisel (Pittsburgh Steelers - DL), Steven Paea (Wash. Redskins - DL). Our goal is to help the athlete become a better player and person through healthy competition against a number of Utah’s best High School programs. Badger Football campers will learn to play the Badger Way: Pride, Discipline, Toughness and Team. Campers will have an experience that they will remember for the rest of their lives as they develop lifelong relationships. We look forward to having you with us! GO BADGERS! Go Badgers!
Payments are to be made to the High School you are currently attending prior to camp. The High School will make one check to Snow College Football. Please direct questions to: Andrew Mitchell, Camp Director.: Phone: 435.283.7656 E-Mail: [email protected]
The Snow College coaching staff will be available to all campers during practice sessions to provide individual coaching. The staff will also be available throughout the day to meet with coaches to simply talk football. Our staff is available to help in any way. Housing All campers and coaches will stay at one of the following off-campus apartment complexes: Snow Garden Apartments or Park Place Apartments. The apartments are fully furnished with Air Conditioning, beds, couches, kitchen, refrigerator, oven, cabinet space, and multiple bathrooms. What to Bring ___ Payment ___ All Football Equipment ___ Medical/Insurance Form ___ Bed Linens (Pillow, Blankets, etc.) ___ Copy of Insurance Card ___ Bathroom Items (Soap,Towels, etc.) ___ Alarm Clock *All players must have Insurance to Participate in Camp* Check-In Information Campers will check in on Sunday evening June 25th or July 16th from 4PM6PM at Badger Stadium. The first meal provided will be Monday’s breakfast. Check-Out Information Camp will conclude Wed, June 28th/July 19th at NOON, at Badger Stadium, following closing remarks by Head Coach Paul Peterson. (No lunch will be served on the final day.) Emergency Telephone Numbers For parents, please acquire cell numbers for your campers coaches. Snow College Main Number: Snow College Training Room: Snow College Football Fax:
435.283.7000 435.283.7022 435.283.7031
Snow College FOOTBALL CAMPS Medical/Insurance Release form Name of Camper _______________________________
High School ________________________________________
Address _______________________________________
City ________________________ State _____
DOB ____________
Insurance Policy Holder Name ________________________
Phone _____________________
*MUST HAVE COPY OF INSURANCE CARD!* Camp Attending (circle one)
Zip _______
Insurance Policy Number _____________________________
Walk-On Tryout Team Camp Individual Camp RELEASE AND WAIVER OF CLAIMS
Youth Camp
In consideration of my child’s/dependent’s participation in the “Snow College Football Camps,” I do hereby, for myself, my child/dependent, my heirs and executors, waive, release and forever discharge all rights and claims for damages and/or injuries for which I or my child/dependent, against “Snow College Football Camps”, employees of Snow College and its agents for any and all injuries and/or damages which may be suffered by my child/dependent in connection with my child’s/dependent’s participation. Parent/Participant Initial ______
PERMISSION FOR MEDICAL ATTENTION The law requires that parental permission be obtained for operative procedures on minors. The parents/guardians need to sign the following consent form so that such procedures may be promptly carried out, and so that no unnecessary delays will occur with operative procedures. However, no operation will be performed, except emergency, without the parents/guardians being contacted and fully informed. I as a parent or legal guardian of (name of camp participant) ______________________, have actual knowledge and appreciation of the particulars of the camp including those risks involved in participation in football camp and hereby voluntarily consent to said minors participation and assume the risks arising there from. With my signature I give my permission for my son/daughter to receive emergency medical procedures deemed necessary. Parent/Participant Initial ______
MEDICAL HISTORY
YES A.
Please explain any
Birth deformities (one kidney, etc.)
B.
Medical Conditions currently under treatment
C.
Pre-Existing injury currently under treatment
D.
Fractures or other disability type injuries
E.
Allergy (drugs, food, asthma, etc.)
F.
Mental disorder
G.
Known past illness of more than one weeks duration
H.
Contact Lens or Glasses
I.
NO
questions answered “YES”
Other condition not listed above
_________________________________________________________________________________________________ _________________________________________________________________________________________________ I hereby state the “Snow College Football Camp” is not responsible for any pre-existing injury or illness of the above camper.
CONCUSSION POLICY If a concussion is sustained during camp, the Snow College training staff will follow the UHSAA Concussion Return to Play policy.
INSURANCE RELEASE “Snow College Football Camps” does not carry insurance for injuries, illnesses, etc… sustained during football camp. Campers participate at their own risk. I hereby authorize my son/daughter to participate in the “Snow College Football Camps” under the above medical release/insurance conditions.
________________________________________________
____________________________________________
Participant Name (Please Print)
Participant Signature
___________________________________________
_________________________________________
Parent/Guardian Name (Please Print)
Parent/Guardian Signature
Date Date
