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INDIANA TRACK AND FIELD CAMPS

2014 HOLIDAY CAMP SESSION I

Jan. 2-4, Bloomington, Indiana
at Gladstein Fieldhouse

daily schedule 

- Jan. 2 - 1:30-4 p.m.
- Jan. 3 - 1:30-4 p.m.
- Jan. 4 - 9-11 a.m.

EVENTS COVERED

- Sprints
- Middle Distance
- Distance
- High Jump
- Long Jump
- Triple Jump
- Hurdles

FOR REGISTRATION INFORMATION:

Phone: 812-855-8583
E-Mail: Click Here!
Register On-Line: Now Available!

$25 summer camp discount if coming with at least five teammates

TO CONTACT IU TRACK AND FIELD:

Phone: 812-855-8583
E-Mail: Click Here!
Mail Questions To:
Indiana Track and Field Camp
Athletic Dept., Indiana University
1001 East 17th Street
Bloomington, IN 47408



All IU Camps are open to all and any entrants

* Add 6% convenience fee for credit card payments

2014 Holiday Camp I

Registration Note: Your camp fee, less a 50% non-refundable administrative deposit will be refunded without question, if you cancel at least two weeks prior to the beginning of camp. At any time after that date, refunds (less the 50% administrative fee) will be made for medical reasons only and must be accompanied by a signed medical statement from your physician within 30 days from the start of camp. If no request for cancellation is made before the camp begins, absolutely no refunds will be given.  

Which day(s) will you be attending camp?*
 All Three Days
 Jan. 2 Only
 Jan. 3 Only
 Jan. 4 Only
 Two Days (please list which two days below)
 
If you selected the two-day option, which two days will you be attending camp?
 
Camper's Name (Last, First)*
 
Home Address*
 
City*
 
State*
 
Zip*
 
Camper's Home Phone #*
 
Parent/Guardian Name(s)*
 
Parent's E-Mail Address*
 
Age*
 
Grade (as of Sept. 2013)*
 
TRACK: Primary Event(s)
 
EMERGENCY NUMBERS  
Father's Home Phone #
 
Father's Cell Phone #
 
Father's Work Phone #
 
Mother's Home Phone #
 
Mother's Cell Phone #
 
Mother's Work Phone #
 
INSURANCE INFORMATION  
Insurance Company*
 
Policy Number/Group #*
 
Name of policy holder*
 
Any past illness or other information that would be useful in the event of medical treatment
 
Allergic Reactions
 
Present Medication (include dosage)
 
WAIVER AND RELEASE  

* I, the undersigned, submit that my son or daughter is physically fit to participate in strenuous athletic activity and I waive the HoosierTrack and Field Camp and Forward Marketing LLC from any and all responsibility for injury or illness. I hereby authorize the directors of Hoosier Track and Field Camp to act for me according to their best judgment in an emergency requiring medical attention. I understand that I am solely responsible for the payment of such medical expenses and provide Hoosier Track and Field Camp proof of medical and accident insurance. I also understand my payment is subject to a 50% handling fee.  

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 any of the Hoosier Track and Field Camps are canceled for any reason, refunds must be collected directly from Hoosier Track and Field Camps, 1001 E 17th St., Bloomington, IN 47408, Phone 812-855-8583.

 
Qty 
 $127.00 Option 1 - Three-Day Camper

 $95.00 Option 2 - Two-Day Camper

 $47.50 Option 3 - Single-Day Camper