2015 SOUTHMOORE FOOTBALL SUMMER PROGRAMS _____________________________________________________________ ATHLETE NAME (LAST) T-SHIRT SIZE: S GRADE (15/16) (FIRST) M L XL 2XL 3XL ATHLETE CELL # EXTRA SHIRT ($20):____________ SIZE SHORT SIZE: S M L XL 2XL 3XL QTY EXTRA SHORT ($25):____________ SIZE QTY _____________________________________________________________ PARENT/GUARDIAN NAME EMAIL PARENT CELL # SOUTHMOORE TEAM CAMP (9TH ONLY) MAY 28 - 29 MUSTANG TEAM CAMP (10TH - 12TH ONLY) JUNE 2 – 4 SUMMER STRENGTH & CONDITIONING (9TH - 12TH) JUNE 22 – AUGUST 6 $150.00 COVERS COST OF APPRORIAPTE TEAM CAMP AND SUMMER STRENGTH AND CONDITIONING PAYMENT DUE BY JUNE 19, 2015 I certify that my child has been examined by a physician and has been found to be in good health and able to compete in all camp activities without restriction. In addition, I acknowledge that I have medical insurance to cover the cost of any injury or illness that may occur during my child’s participation in this camp. Furthermore, I authorize the Southmoore Football Staff to act for me according to their best judgment in an emergency requiring medical attention. I hereby release the Southmoore Football Staff and Moore Public Schools from any civil or monetary damages due to injury sustained while attending these programs. _____________________________________________________________ PARENT/GUARDIAN NAME (PRINT) Mail application and fee to: Southmoore Football 2901 S. Santa Fe Moore, OK 73160 DATE Make checks payable to: Southmoore Football PARENT/GUARDIAN SIGNATURE