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KEVIN WILSON FOOTBALL CAMPS AT INDIANA UNIVERSITY

2014 FRIDAY NIGHT LIGHTS

June 20
Bloomington, Indiana
at Indiana University

CAMP COSTS

$50.00

CAMP DETAILS

- Open to Rising Grades 11-12
- Registration- 6-7  p.m .
- Camp from 7-10 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 Kevin Wilson Football Camps at 812-855-9618 for qualification requirements


2014 Friday Night Lights

As of June 19, registration for Friday Night Lights 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.

Please complete the form below and submit camp payment.
 
Camper's Name (Last, First)*
 
Height*
 
Weight*
 
Home Address*
 
City*
 
State*
 
Zip*
 
Camper's Home Phone #*
 
Camper's Cell Phone #
 
Camper's E-Mail Address*
 
Parent's E-Mail Address*
 
Parent/Guardian Name(s)*
 
Father's Cell Phone #
 
Mother's Cell Phone #
 
Grade Entering*
 
Camper's School*
 

Position (select one)*
 QB
 RB
 WR
 TE
 OL
 DL
 LB
 CB
 S
 K/P
 LS
 
T-Shirt*
 M
 L
 XL
 XXL
 

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

MEDICAL & LEGAL WAIVER - I certify my child was examined by a physician prior to June 10, 2014, 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, Forward Marketing LLC, and its employees from any injuries incurred in the camp. I, the undersigned parent/guardian, do hereby 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, Forward Marketing LLC, their 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 are 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.
 
Qty 
 $50.00 Friday Night Lights Registration - Payment in Full