I, the undersigned, hereby expressly and affirmatively state that I wish to participate in the Warrior Youth Football Camp. I realize that my participation in this activity or the use of equipment involves various risks of injury. In consideration of being allowed to participate in the activities and programs provided through Susquehannock High School, I do hereby waive, release and forever discharge Susquehannock High School, and all of its directors, officials, agents, employees, representatives, event staff, and all other affiliates from any and all responsibility or liability for injuries or damages resulting in this activity. I do also hereby release all of those mentioned, and any others acting upon their behalf , from any responsibilities or liability for any injury or damage to myself, including those caused by the negligent act or omission of any of those mentioned or others acting on their behalf, or in any way arising out of or connected with my participation in any of the contemplated activities or in the use of equipment through Susquehannock High School, or otherwise.
Warrior Football
Parent/Guardian Signature _____________________
Susquehannock High School, 3280 Fissels Church Road, Glen Rock, PA 17327. Attn: Youth Football Camp
PLEASE DIRECT ALL QUESTIONS TO: Steve Wiles @ 717 507-2290 Or
[email protected] WARRIOR YOUTH FOOTBALL CAMP
MEDICAL WAIVER
FOR STUDENTS CURRENTLY IN GRADES 3-8
DATE: TIME: LOCATION: Susquehannock High School Football Field
NON-CONTACT SKILLS CAMP
CAMP APPLICATION
COACHING STAFF Steve Wiles—Head Varsity Coach
Players will learn the basic fundamentals of the game. Including passing, catching, blocking, tackling, punting, and kicking.
Price
Sign up for:
ASST. VARSITY COACHES
Pre Registered - Single Camper
$50.00 each
Pre Registered - Multiple Campers
$30.00 each
Bill Kerr
Walk up Registration
$60.00
Scott Mathena Rory Hertzog Errol Herrigan Total:
This Non-Contact program provides step by step instruc-
Additional Staffing provided by Junior High Staff and Warrior Varsity Players
tion and demonstration in all
COST
aspects of the game...including
Pre– Registered - $50.00 per camper ( includes Camp T-Shirt, and Awards)
NAME ADDRESS
PHONE
CURRENT GRADE
footwork, quickness, and agility
drills for developing young athletes. Coaching tips on stances, receiving, blocking, running, and safe tackling techniques. Instruction on punting, kicking, and snapping will also be
provided. Each player will be introduced to the Warrior Football Program and begin
Families with MULTIPLE CHILDREN ARE $30.00 per player. Walk-Up Registration - $60.00 per camper. EQUIPMENT Shirts, Shorts, Sneakers and or Football Cleats should be worn each day.
SHIRT SIZE (CIRCLE ONE) YL
AS
AM
AL
AXL
AXXL
Method of Payment Checks are payable to All Sports Booster Club. Payments are due by June 8 , 2015. All Profits will benefit the Football Programs.
REGISTRATION: Monday, June 15 beginning @ 5:30PM at the High School Football Field * BONUS * PUNT,PASS, & KICK COMPETITION
Susquehannock High School, 3280 Fissels Church Road, Glen Rock, PA 17327.
developing a winning attitude through hard work, dedication, and team spirit.
PLEASE DIRECT ALL QUESTIONS TO: Steve Wiles @ 717 507-2290 Or
[email protected]