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 2015 LINFIELD WILDCAT FOOTBALL CAMP • 6 National Championship Appearances • 58 Consecutive Winning Seasons • • Conference Champions ’00, ’01, ’02, ’03, ’04, ’05, ’09, ’10, ’11, ‘12 ‘13• • 2004 NATIONAL CHAMPIONS • 2015 LINFIELD CAMP REGISTRATION FORM Camp 2-­‐ June 14th – 17st Residence Hall Camper** $235 Tuition Once completed, deliver this form and your deposit to your team coach. PARENTS: Please complete application in full. It will not be accepted without medical info including insurance & signature. Please Print Camper Name: _______________________________________________ High School: __________________________________________________ Age: ____________ Grade (Fall’15):____________________________ E-­‐mail: ________________________________________________________ Mailing Address:_____________________________________________ City: ___________________________________________________________ State/Zip: ____________________________________________________ Home Phone: ________________________________________________ Work Phone: _________________________________________________ Parent’s Name (first & last): ________________________________ ________________________________________________________________ Allergies: _____________________________________________________ Chronic Conditions (e.g. asthma): __________________________ Regular Medication: _________________________________________ Medical Insurance Carrier: _________________________________ What to Bring: Personal football equipment (Pads, Helmet, Mouthpieces) Sleeping Bag Pillow Towels and Washcloths Swimsuit and toiletries Important Information: No athlete will be allowed to leave prior to the final day of camp without special permission from the camp director. The camp staff reserves the right to request the removal of a player who displays unacceptable behavior during the course of the camp. All campers are required to provide their own medical insurance (see registration form section). A trainer will be available during all sessions and on call the entire time. For the safety of all the athletes attending the camp, parents are requested to have their sons take a physical exam prior to the arrival to camp *Policy Number: _____________________________________________ I hereby authorize the staff of the Linfield Football Camp to act for me according to the best judgment in any emergency requiring medical attention. I also hereby waive and release Linfield College and the staff of the Linfield Football Camp from any and all liability for any injuries while my son is at camp. I have knowledge of any physical impairment that would affect my son’s participation in the camp. Parent/Guardian Signature: _____________________________________________________________ Date: _____________________________ Chris Adams – Director of Conference Services 503-­‐883-­‐2448 [email protected]