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KEVIN WILSON FOOTBALL CAMPS AT INDIANA UNIVERSITY

2013 I CAMPS

June 11-14 & 17-19 Bloomington, Indiana
at Indiana University

CAMP COSTS

$50.00

CAMP DETAILS

- Open to Grades 10-12
- Registration - 1-2 p.m. (Glory Plaza, North End Zone Facility)
- Camp - 2-5:15 p.m.
- Post-Practice Meal

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


2013 Individual One-Day Camps

As of 7:30 a.m. June 19, on-line registration is closed.
 
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.
 
Which camp date will you be attending?*
 

Camper's Name (Last, First)*
 
Home Address*
 
City*
 
State*
 
Zip*
 
Camper's Home Phone #*
 
Camper's Cell Phone #
 
Parent/Legal Guardian Name(s)*
 
Parent/Guardian E-Mail Address*
 
Father's Cell Phone #
 
Mother's Cell Phone #
 
Camper's School*
 
What grade will you be entering in the fall of 2013?*
 
Height*
 
Weight*
 
Position (select one)*
 QB
 RB
 WR
 TE
 OL
 DL
 LB
 CB
 S
 K/P
 
T-Shirt Size*
 M
 L
 XL
 XXL
 
INTERNAL - Campers leave next space blank  
Registration Notes
 

CAMPER INSURANCE INFORMATION

 
Name of Minor*
 
Insurance Company*
 
Policy Number/Group #*
 
Name of Policy Holder*
 
Insurance Company Phone #
 
Any past illness, injury or other information that would be useful in the event of medical treatment
 
If the camper should be restricted from any activity, please note
 
Deductible Amount
 
Father's Work Phone #
 
Mother's Work Phone #
 
In case parent/guardian can't be reached, what is the name, phone # and relationship of another person we can call?*
 

MEDICAL CONSENT - I certify my child was examined by a physician prior to June 10, 2013, 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. Any costs not covered by your insurance as the sole responsibility of the parent or guardian. 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.  

LEGAL WAIVER - In consideration of being allowed to participate in the Kevin Wilson Football Camps at Indiana University, I, for myself, my heirs, personal representatives or assigns, do hereby release, waive, discharge and covenant not to sue KRW LLC, its officers, employees and agents for liability from any and all claims including the negligence of the Kevin Wilson Football Camps at Indiana University, its officers, employees and agents, resulting in personal injury, accidents or illnesses (including death), and property loss arising from, but not limited to, participation in the Kevin Wilson Football Camps.
 

Parent/Legal 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.
 
Qty 
 $50.00 Individual Registration - Payment in Full