APPLICATION INFORMATION
————————————— SOUTH FOOTBALL YOUTH CAMP APPLICATION
Make Checks to: BHSS Youth Football Camp
Physicals: We str ongly r ecommend that all campers complete a physical exam. Sixth, seventh, eighth, and ninth grade athletes should use a school physical form which would take care of the athletic physical requirement for the 2013-2014 school year. I hereby authorize the directors of the SOUTH PANTHERS FOOTBALL CAMP to act for me according to their best judgment in any emergency requiring medical attention, and hereby waive and release the SOUTH FOOTBALL CAMP, MONROE COUNTY SCHOOLS, AND SOUTH STAFF from any and all liability for any injuries and illness incurred while at camp. I will be responsible for any medial charges or any other charges incurred in connection with my child’s attendance at the camp.
Send to: Attn: Mo Moriarity Bloomington High School South Football 1965 S. Walnut St. Bloomington, IN 47401
He is covered by_________________________________________
2015 Panther Football Youth Camp
(Name of insurance company)
Signature of parent
Registration does not close. Walk-in registration will be accepted with a late fee.
Equipment T-shirt, gym shorts and football cleats.
or legal guardian ________________________________________
Primary Phone ___________________________
Emergency ______________________
Participant’s name: ______________________________________
Address:
_______________________________________
Arrival time is 10 to 15 minutes before practice.
___________________________________________
Circle grade this fall:
3 4 5 6
Circle correct t-shirt size Youth M L Adult S M L XL XXL XXXL
Make check payable to: BHSS Youth Football Camp
with Bloomington South Head Coach Mo Moriarity and Gabe Johnson
July 6-8, 2015 for grades 3 through 6 At Bloomington South High School Football Stadium
Tear off — Keep
Instructors: Coach Moriarity, the entire Bloomington South High School Coaching Staff
Who: Players who will be in third, fourth, fifth, and sixth grades this coming fall! When: J uly 6-8 (one-week commuter format) (Mon.—Wed.) grades 3-6, 10:30 a.m. to 11:45 a.m.
Bloomington South Youth Football Camp July 8-11, 2013 SOUTH FOOTBALL STATE CHAMPIONS:
1968, 1972, 1993, 1998
Registration: Make Checks Payable to: BHSS Youth Football Camp Please send your registration form and check to: Attn: Mo Moriarity Bloomington High School South Football 1965 S. Walnut St. Bloomington, IN 47401
Mark your calendar now! 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
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.
Cost: Grades 3-6 $40
Walk-in registration: Grades 3-6- $45