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SANTA BARBARA HIGH SCHOOL
DONS FOOTBALL CAMP
Coach Stone, Staff and Alumni are proud to present:
A up tempo camp designed to teach and apply fundamentals in a competitive game speed environment. The
camp will consist of conditioning and football specific training. Instruction will be given by experienced
Coaches, Alumni and former college football players to better assist your child. Be prepared to work hard,
compete and most of all have fun!
THE 3rd ANNUAL YOUTH SUMMER CAMP
Football • Speed • Skills & Development
Special Guest Trainers
Monte' Nash - Creator of the Speedsac Sad-Sled and developer of the I.M.F.A.S.T strength training program
Kareem Larimore - Former Dallas Cowboy and Arena Football star. Co Founder of "Camp Shutdown"
Chris Phillips - Founder of Muscle Activation South Bay and Co-Founder of "Camp Shutdown"
June 15th thru June 18th
Monday thru Thursday: 4:00 – 6:30 p.m.
SANTA BARBARA HIGH SCHOOL PEABODY STADIUM
CAMP ELIGIBILITY:
Ages 8-14
CAMP COST:
Pre-Registration
$50.00 (by June 8th, 2015)
On-Site
$60.00 (Providing there are open slots. Space is limited.)
Cost Includes:
The best training, camp tee-shirt, & Thursday BBQ
EQUIPMENT:
All participants are to wear athletic shorts, cleats and water
DAILY CHECK-IN:
Campers must check-in at Peabody Stadium daily at 3:30pm.
MAIL FORM & PAYMENT TO:
Ye Ole Gang /Santa Barbara Dons Football Alumni
P.0. Box 579
Santa Barbara, CA 93116
REGISTRATION FORM
DONS FOOTBALL CAMP
Camper Info/Información de Campista:
Name/Nombre: __________________________________________________________ Age/Edad: _________________
Address/Domicilió: _____________________________________________________________________________________________________________
City/Cuidad: __________________________________________________________________________Zip/Código Postal: _____________________
Email: _____________________________________________________________________________________________________________________________
Position(s): □ QB, □ WR, □ RB, □ TE, □ OL, □ SS, □ FS, □CB, □ LB, □ DE, □DT, □K , □ P
Number or years of football experience, if any:____________________
Contact Info/Información de contacto:
Home Phone/Numero de Teléfono: __________________________ Cell/Celular: ________________________________
Parent(s) Name/Nombre de Padre(s: _________________________________________________________________________________________
Emergency Contact/Contacto de Emergencia: _______________________________________________________________________________
Phone/Teléfono: ____________
(other than parent/que sea otra person )
Medical Info/Informacion Medical:
Health Insurance/Seguransa: _____________________________Policy# __________________
Conditions/Allergies/Condiciones/Allergias: __________________________________________
___________________________________________________________________________________
____________
Camp Session/Sesion de Campo: Camper T-Shirt Size/Tamano de Camiseta: S____ M____ L____ XL ____ XXL____
Adult size □ or Youth size □ (Place a check in box for Adult or Youth Size)
Payment/Pago: Cashiers Check: _____ Check: _____
Amount Enclosed: ____________
Please make checks payable to: “Ye Ole Gang”
Any questions contact:
Coach Stone at [email protected] or (805) 612-0016
Sam Cuellar at [email protected] or (805) 797-0763
Consent to Treatment of Minor/El consentimiento para el tratamiento de menores
In the event of sudden illness, accident or injury which may occur while said minor is engaged in an activity supervised by the Santa
Barbara High School Dons Football Camp and their representatives, agents or assignees, when neither parents, nor designated family
physician can be contacted, I hereby give my consent pursuant to California Family Code 6910 for emergency treatment as shall be
necessary under the circumstances by any physician licensed under laws of the State of California.
I understand and acknowledge that in order to participate in this activity, I and my son/daughter agree to assume liability and
responsibility for any and all potential risks that may be associated with participation in the Santa Barbara High School Dons
Football Camp.
I agree to, and do hereby release and hold the District and its officers, agents, employees and/or volunteers harmless for any and
all claims; demands, causes of action; liability; damages, expenses; or loss of any sort, including bodily injury or death; because of
or arising out of acts or omissions with respect to the sport.
I acknowledge that I have carefully read the registration form and that I understand and agree to its terms.
En caso de enfermedad repentina, accidente o lesiones que se pueden producir mientras dicho menor participa en una actividad
supervisada por el rojo Santa Barbara High School Dons Football Camp y sus representantes, agentes o cesionarios, cuando ni los
padres ni designado médico de familia puede ser contactado. Por la presente doy mi consentimiento con arreglo al 6910 de
código de familia de California para tratamiento de emergencia, será necesario en las circunstancias por cualquier médico
licenciado bajo las leyes del Estado de California.
Comprendo y reconocer que para poder participar en esta actividad, yo y mi hijo(a) acepta asumir la responsabilidad y la
responsabilidad de todos riesgos potenciales que pueden estar asociados con la participación en el campo de fútbol de Santa
Barbara High School Dons. Estoy de acuerdo y crea liberar y eximir del distrito y sus funcionarios, agentes, empleados y
voluntarios para todo reclamo; demandas, causas de acción; responsabilidad; daños y perjuicios, gastos; o pérdida de ningún
tipo, incluyendo lesiones corporales o muerte; por o resultantes de actos u omisiones en relación con el deporte.
Reconozco que he leído cuidadosamente la forma de registro y comprendo y acepto sus términos.
_________
Date/Fecha
____
_________________________________________
Signature of Parent/Firma de Padre
_________________________________________________
Signature of Participant /Firma de Participante
_____________________________________________________________
Family Physician and Phone/Nombre de Doctor y Numero