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TOM ALLEN FOOTBALL CAMPS AT INDIANA UNIVERSITY

2017 SPECIALISTS DAY CAMP

June 16
Bloomington, Indiana

CAMP COSTS

$150.00

CAMP DETAILS

- Rising Grades 9-12
- Registration-8-9 a.m.
- Camp begins at 9 a.m.
- Camp concludes at 3:30 p.m.


All camps open to all and any entrants

FOR REGISTRATION INFORMATION/INQUIRIES:

- Phone: 1-319-631-0946
- E-Mail: For Further Information!
- Register On-Line: Now Available!
- Download Camp Brochure: Coming Soon!

Individual and/or Team Discounts available for One-Day and Three-Day Team Camps only; call Tom Allen Football Camps at 319-631-0946 for qualification requirements
Indiana University Employees and Tom Allen Football Camp Employees are eligible for 50% off the camp registration price. Please contact Coach William Inge for more information.
I-Camp Group Rate: Groups of 15 or more are eligible for a discount of 50% off for the registration price. Please contact Coach William Inge for more information.


2017 Specialists Camp

Registration is Closed for this Camp

 
Registration Note Space is limited so we encourage campers to register as soon as possible. Full payment is required to register for Tom Allen Football Camp. All monies, less the $50 non-refundable administrative fee, will be refunded for medical purposes only and must be accompanied by a physician's letter of explanation prior to the start of camp. Camp may be prorated on a daily basis. If you have questions, please call 319-631-0946.
 
Camper's Name (Last, First)*
 
Height (i.e. 6'1")*
 
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 #
 
High School Attending*
 
Grade Entering (Fall 2017)*
 
Position (Select One)*
 
T-Shirt Size*
 M
 L
 XL
 XXL
 

CAMPER INSURANCE INFORMATION
 
Name of Minor*
 
Insurance Company*
 
Name of Policy Holder*
 
Policy Number/Group #*
 
Deductible Amount
 
Insurance Company Phone #
 
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?*
 
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 9, 2017, 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 Tom Allen 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 Tom Allen 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 Indiana Football Camp is cancelled for any reason, refunds must be collected directly from the Tom Allen Football Camps.
 
Qty 
 $150.00 Individual Registration - Payment in Full