BIG 30 FOOTBALL CAMP 2015 Monday, June 29th — Thursday, July 2nd at Please complete and retur n the following:  Camper Registration For m  Parent Per mission For m  Bus Reser vation For m  Cur rent Physical and Immunizations (you will not be able to participate without medical forms)  $150 deposit or full payment Mail all information with payment to: Baldwinsville Football Alumni Association 74 Oswego Street Baldwinsville, NY 13027 Checks payable to: Baldwinsville Football Alumni Association Camp-$279 Bus-$45 Questions? Call/Email Coach Sanfilippo Office—(315) 638-6014 Cell—(315) 882—3678 Email—[email protected] BIG 30 FOOTBALL CAMP 2015 REGISTRATION FORM Student Name: ____________________________________________ Date of Birth: _______________ Grade (Fall 2015) : 12 11 10 9 8 7 School: ____________________________ Street Address: ___________________________________________________________________ City ___________________________ State _________ Zip_______________ Parent/Guardian Name: ___________________________________ Relationship: ________________ (home) ______________________ (cell) ______________________ (work) ______________________ Email: ________________________________________________ Parent/Guardian Name: ___________________________________ Relationship: ________________ (home) ______________________ (cell) ______________________ (work) ______________________ Email: ________________________________________________ Cost of camp is $279 - Deposit of $150 due with registration Checks payable to: Baldwinsville Football Alumni Association Amount paid: __________________ Cash/Check # ____________ Bus Registration The coaching staff has arranged for transportation to and from the football camp. Seats are reserved on a first come/first serve basis. To reserve a seat on the bus, please fill out this form Cost of bus is $45 - Checks payable to: Baldwinsville Football Alumni Association Student Name: ______________________________________________ Amount paid: _______________ Cash/Check # _____________ BIG 30 FOOTBALL CAMP 2015 PARENT FORM Student Name: _______________________________________ Date of Birth: ________________ My son has my permission to participate in the Big 30 Football Camp on the campus of Utica College from Monday, June 29th to Thursday July 3rd, 2015. Parent/Guardian Signature: __________________________________ Date: _________________ In case of emergency, please contact: Name: ______________________________________________ Relationship: _____________________ (home) _____________________ (cell) _____________________ (work) ______________________ Authorization for treatment of minor: I/we being the parent(s) or legal guardians of the named minor, do hereby appoint the staff of the Big 30 Football Camp to act on my/our behalf in authorizing unexpected medical, dental, surgical care and hospitalization for the above named minor for the length of the football camp: Monday, June 29th to Thursday, July 3, 2015. Parent/Guardian Signature: __________________________________ Date: _________________ Hospitalization Coverage: Insurance Company: ________________________________ ID # _____________________________ Family Physician: ___________________________________ Phone: __________________________ ** This form must be completely filled out and returned with current physical/immunization records or you will NOT be allowed to attend camp.