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MOLINE HIGH SCHOOL
FOOTBALL CAMP 2015
WHEN:
HIGH SCHOOL - JUNE 29 THROUGH JULY 17 - 8:00-10:00 AM
JR. MAROON / GRADES 3-8 – JULY 6 THROUGH JULY 9 - 10:15-11:30 AM
WHERE:
COOLIDGE
COST:
HIGH SCHOOL - $55
JR. MAROON - $20
_____________________________________________________________________________________
Camp registration form
Please complete and return to Coach Tracey before June 2ND
Please mail to:
Mike Tracey
3600 Avenue of the Cities
Moline, IL 61265
Make checks payable to: Moline School District - Football Camp
NAME__________________________________________PHONE______________________________
ADDRESS: ___________________________________________________________________________
Grade for fall 2015________Player(s) current school__________
T-Shirt Size: YOUTH: M - L (CIRCLE ONE) ADULT: S - M - L - XL - XXL - XXXL (CIRCLE ONE)
We the parent/guardian of ___________________________________hereby gives our approval for our
child to participate in any or all Moline HS Football camp activities. We do hereby waive, release,
absolve, and indemnify and agree to hold harmless the camp, coaches, counselors, directors, and Moline
School District #40. We grant permission for our child to participate in the camp and acknowledge that
he is physically able to participate in camp activities.
Parent/ guardian signature: ________________________________________Date_________________
Emergency contact number: _____________________________________________________________
Parent/guardian e-mail address: __________________________________________________________
Come dressed in a t-shirt, shorts/sweatpants, and football shoes (no baseball spikes). Do not wear shirts
promoting, alcohol, music, slogans that may offend others etc. No earrings worn once you step on the
football facility grounds.
**********REGISTRANTS AFTER JUNE 2, 2015 CANNOT BE GUARANTEED A CAMP T-SHIRT**********