SOUTH FOOTBALL YOUTH CAMP APPLICATION PHYSICALS: We strongly recommend that all campers complete a physcial exam. I hereby authorize the directors of the SOUTH FOOTBALL YOUTH CAMP to act for me according to their best judgement in any emergency requiring medical attention, and hereby waive and release the SOUTH FOOTBALL YOUTH CAMP, MONROE COUNTY COMMUNITY SCHOOLS, AND SOUTH STAFF from any and all liability for any injuries and illness incurred while at camp. I will be responsible for any medical charges or any other charges incurred in connection with my child’s attendance at the camp.
He is covered by: _______________________ (Name of insurance company)
Signature of parent or legal guardian: ___________________________________________ Primary Phone: __________________________ Emergency Phone: ______________________ Participant’s Name: _____________________ Address: _________________________________ ___________________________________________
4
5
6
Circle correct t-shirt size Youth:
M
L
Adult:
S
M
L
Make Checks Payable to:
BHSS Youth Football Camp
Send to: Attn: Mo Moriarity BHSS Football 1965 S. Walnut St. Bloomington, IN 47401 Registration does not close. Walk-in registration will be accepted with a $5 late fee. Equipment: T-shirt, gym shorts, and football cleats Arrival time is 10 to 15 minutes before practice except on the first day when we request you being there 30 minutes early.
Circle participant grade this fall: 3
APPLICATION INFORMATION
XL
2017 Panther Football Youth Camp with Bloomington South Head Coach Mo Moriarity July 10-12, 2017 For Grades 3-6 At Bloomington High School South Football Stadium Instructors: Coach Moriarity and the entire BHSS Football Coaching Staff
Who
Players who will be in the 3rd, 4th, 5th, and 6th grades this coming fall
When
July 10-12 (Mon. - Wed.) 10:30 a.m. - to 11:45 a.m.
Players should arrive 30 min. early on the first day of camp
Where
Bloomington High School South Football Stadium
1965 S. Walnut St. Bloomington, IN 47401
Bloomington South Youth Football Camp July 10-12, 2017 SOUTH FOOTBALL STATE CHAMPIONS: 1968, 1972, 1993, 1998
Program Proper stretching methods, correct running techniques, agility drills, special kicking skills, and instruction for both offensive and defensive positions will be taught. Drills, techniques, terminology, and methods used by the high school and each middle school will be emphasized.
Registration Make checks payable to:
BHSS Youth Football Camp Please send your registration form and check to: Attn: Mo Moriarity BHSS Football 1965 S. Walnut St. Bloomington, IN 47401
Cost
Mail-in registration $40
Walk-in registration $45