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KEVIN WILSON FOOTBALL CAMPS AT INDIANA UNIVERSITY

2012 ELITE CAMP I

June 10, Bloomington, Indiana
at Indiana University

CAMP COSTS

$25.00

CAMP DETAILS

  • Open to Grade 12

  • Registration - 12-1 p.m.

  • Camp - 1-6 p.m.

WHAT TO BRING

  • Helmet & Shoulder Pads (if your state allows you to bring them)


All camps open to all and any entrants

FOR REGISTRATION INFORMATION/INQUIRIES:

- Phone: 1-812-855-9618
- E-Mail: For Further Information!
- Register On-Line: Coming Soon!
- Download Camp Brochure: Click Here!

Individual and/or Team Discounts available for One-Day and Three-Day Team Camps only; call IU Football at 812-855-9618 for qualification requirements


2012 IU Football Elite Camp I

AS OF JUNE 9, ON-LINE REGISTRATION CLOSED FOR 2012 IU FOOTBALL ELITE CAMP SESSION I
To check on the possibility of late registration, please call the IU Football Office at 812-855-9618

 
Registration Note Space is limited so we encourage campers to register as soon as possible. A confirmation letter, player medical forms, and general information will be sent once payment is received.
 
Camper's Name (Last, First)*
 
Home Address*
 
City*
 
State*
 
Zip*
 
Camper's Home Phone*
 
Camper's Cell Phone #
 
Parent/Guardian Name(s)*
 
Parent's E-Mail Address*
 
Father's Cell Phone #
 
Mother's Cell Phone #
 
Camper's School*
 
Grade Entering (Fall '12)*
 11
 12
 
Height*
 
Weight*
 
Position (Select one)*
 QB
 RB
 WR
 TE
 OL
 DL
 LB
 CB
 S
 K/P
 
T-Shirt Size*
 M
 L
 XL
 XXL
 

CAMPER INSURANCE INFORMATION

 
Name of Minor*
 
Insurance Company*
 
Name of Policy Holder*
 
Policy Number/Group #*
 
Insurance Company Phone
 
Deductible Amount
 
Mother's Work Phone #
 
Father's Work Phone #
 
Emergency contact if parents can't be reached
 


MEDICAL CONSENT FORM
I certify my child was examined by a physician prior to June 8, 2012, and found to be in good health and able to participate in all athletic activities without restriction.

I hereby release and exonerate and discharge the camp and its employees from any injuries incurred in the camp. I, the undersigned parent/guardian, do herby delegate to the Kevin Wilson Football Camp, its employees or agents the authority to seek, obtain, and approve any medical care and treatment for the below-named minor, which in their judgment is necessary for the health and well-being of said minor during his attendance at the Kevin Wilson Football Camp.

Further, I agree to hold the Kevin Wilson Football Camp, its employees, or agents harmless for any liabilities arising out of any good faith actions taken in seeking and obtaining medical care and treatment for the below-named minor. I authorize these medical vendors (Indiana University Health Center and Bloomington Hospital, or such other medical providers to whom I am referred by named sources for x-ray, laboratory or other diagnostic or therapeutic services) to release any information required in applying for payment on my behalf and I hereby assign payment of these medical vendors for all services that these medical vendors may render.

Any costs not covered by your insurance as the sole responsibility of the parent or guardian.
 

Parent/Guardian Name*
 
Date*
 

PAYMENT OPTIONS
Please select your payment option by indicating a '1' in the quantity field. We need a registration form and consents completed for each participant.

Note: A charge from Hoosiersportscamps.com will appear on your credit card for your on-line registration. However, if the IU Football Camp is cancelled for any reason, refunds must be collected directly from the Kevin Wilson Football Camps at Indiana University, Phone 812-855-9618.