Skip to main content

INDIANA FIELD HOCKEY CAMP

HOOSIER Field Hockey Team Camp

July 6-8, 2017
Bloomington, Indiana, at Indiana University

CAMP DETAILS

Ages 12-18

Overnight - $399.00

Commuter - $340.00

DISCOUNTS

Team Discount (May 15 deadline) - $20* for teams bringing 13 or more players

Early Registration Discount (April 1 deadline) - $20*

* Only one discount can be applied per registration

FOR REGISTRATION INFORMATION:

Problems Registering? Call 812-345-7759
E-Mail: Click Here!
Register On-Line: Now Available!
What to Bring to Camp: Click Here!
Download 2017 Camp Brochure: Click Here!

TO CONTACT COACH JANNEY:

E-Mail: CLICK HERE




All Indiana Camps are open to all and any entrants


2017 Indiana Field Hockey Camp

As of July 3, on-line registration is closed. No additional registrations can be accepted.

 

HOOSIER FIELD HOCKEY CAMP REGISTRATION - JULY 6-8, 2017

Registration Note - Registrations will be accepted until the camp is full. No refunds or cancellations will be accepted less than two weeks prior to the start of camp. Cancellations received two weeks prior to the start of camp will receive a refund of the registration fee minus a $75 administrative fee. No refunds will be made if a child is withdrawn within two weeks of the start of each camp.

If you have questions, please e-mail HoosierFH@gmail.com.

Please complete the form below and submit camp payment.

 
Camper's Name (Last, First)*
 
Camper's E-Mail Address*
 
Camper's Home Phone #*
 
Camper's Cell Phone #
 
Birthdate (Month/Day/Year)*
 
Experience (select one)*
 

Camper's Field Hockey Position (select one)*
 

If selected Other for position, write in here
 
Parent/Guardian Name(s)*
 
Home Address*
 
City*
 
State*
 
Zip*
 
Emergency Contact (Name, relationship)*
 
Emergency Contact E-Mail Address*
 
Emergency Contact Cell Phone #*
 
Camper's School*
 
Name of Club Team
 
If selecting the team discount, name of team or club that will have 13 or more team members register
 
Are you eligible for a $15 sibling discount? (Note: to be eligible, at least two siblings must sign up for the Hoosier Field Hockey Camp. The refund will be issued on your credit card after you have submitted payment and both siblings have registered)*
 No
 Yes
 
HS Graduation Year (i.e. 2019)*
 
T-Shirt Size (adult sizes)*
 XS
 S
 M
 L
 XL
 XXL
 
Roommate Preference
 

PARENTAL CONSENT FORM
In order to enable health facilities in Bloomington to provide prompt care to your daughter, we urge you to read and complete this Consent Form. This will enable us to help your child without delay in the event of an emergency.NOTE: Please complete EVERY field on the medical/parental consent form!
 
Name of Minor*
 
Insurance Company*
 
Policy Number/Group #*
 
Name of Policy Holder*
 
Allergic Reactions
 
Present Medication (include dosage)
 
List of surgeries
 
Date of Last Tetanus Toxoid
 

* I grant permission to the Directors, Assistants, or other persons responsible for her care to act on my behalf for said minor in granting permission for evaluation and treatment of medical problems. I understand that should a major medical problem arise, an attempt will be made to notify me by telephone. In the event that I cannot be reached, I hereby give my consent to such medical treatment as deemed necessary, including surgery, x-ray examinations and anesthesia to be rendered to said minor by a licensed physician or nurse.  

* I authorize the Hoosier Field Hockey Camp to photograph my child in camp activities for promotional purposes.  

* WAIVER:In consideration of being allowed to participate in the Hoosier Field Hockey Camp,I,for myself, my heirs, personal representatives or assigns, do hereby release, waive, discharge and covenant not to sue Hoosier Field Hockey Camp, Sweet D Field Hockey, LLC, Forward Marketing LLC, their officers, employees and agents for liability from any and all claims including the negligence of the Hoosier Field Hockey Camp, 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 Hoosier Field Hockey Camp.  

* By my submission of this registration, I represent that I am either 18 years of age or older, or that I am the parent or legal guardian of the registrant (if he/she is under age 18).I represent I have read the terms of the Privacy Policy,that I understand the manner in which the information collected about the registrant may be used, and that I agree to the use of the registrant’s personally identifiable information in the manner described in the Privacy Policy.  

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 Field Hockey Camps are cancelled for any reason, refunds must be collected directly from the Hoosier Field Hockey Camp, Hoosierfh@gmail.com.
 
Qty 
 $399.00 Option 1 - Overnight Registration - Payment in Full

 $340.00 Option 2 - Commuter Registration - Payment in Full