2016 hilltopper football camps - Western Kentucky Football Camps

2016
hilltopper
football
camps
PLEASE CHECK THE APPROPRIATE BOX
wku p ro sp ect camp
j un e 4 - $ 50
wku p ro sp ect camp
j uly 16 - $ 50
s at e llite ca m p : col l ins hs
j u n e 9 - $ 30
s at e llite ca m p : gal l atin hs
j u n e 13 - $ 30
s at e llite ca m p : mccr acken co. hs
j u n e 14 - $ 30
w ku s p ecia lists ca mp
july 2 2 - $ 8 0
f ut u r e top p e r yo u t h ca mp
june 6 - 8 - $ 75
PARENT/GUARDIAN INFORMATION
NAME ____________________________
RELATIONSHIP TO CAMPER______________
HOME PHONE _______________________
WORK PHONE _______________________
MOBILE PHONE ______________________
INSURANCE COMPANY _________________
POLICY NO. ________________________
JEFF BROHM
WKU HEAD COACH
PARENT/GUARDIAN RELEASE
I, the undersigned, hereby certify that I am the parent or legal
guardian of the camper. I hereby give permission for the staff of
the camp to seek, during the camp, appropriate medical attention
for the camper and for the medical attention to be given and for
the camper to receive medical attention in the event of accident,
injury or illness. i will be responsible for any and all costs of
medical attention and treatment, except for that covered by the
camp’s Excess coverage policy. I, the undersigned, for ourselves, our
heirs, executors, and administrators, waive, release, and forever
discharge Western Kentucky University, its Board of Trustees, and
the camp and its staff, officers, agents, employees, representatives,
successors, and assign of and from all rights and claims for
damages, injury, or loss to person or property which may be
sustained during participating in camp activities or while at camp,
whether or not damages, injury or loss is due to negligence.
It shall be understood that participating campers are contracting
with the employee and not Western Kentucky University, and the
University and the state of Kentucky do not assume any contractual obligations for the conduct of the employee’s activity.
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pa r e n t / g u a r d i a n n a m e
(please
print)
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pa r e n t / g u a r d i a n s i g n at u r e
WKU FOOTBALL
HOUCHENS-SMITH STADIUM
1605 AVENUE OF CHAMPIONS
BOWLING GREEN, KY 42101
TO REGISTER ONLINE, VISIT
WKUFOOTBALLCAMPS.COM
FOR MORE INFORMATION, CALL
270.745.5311
CHAMPIONS
wku football camps are open to any and all entrants, limited only by number, age, grade
level, and/or gender. all camps will be non-padded. t-shirts, shorts, and shoes only.
registration for each camp will begin one hour prior to camp start time.
WKU PROSPECT
CAMPS
SATELLITE PROSPECT
CAMPS
JUNE 4 & JULY 16, $50 PER PERSON
JUNE 9, 13 & 14, $30 PER PERSON
HOUCHENS-SMITH STADIUM
BOWLING GREEN, KY
STUDENTS ENTERING GRADES 9-12
CAMP WILL RUN 12:00 PM-3:00 PM CST
WKU SPECIALISTS
CAMP
JULY 22, $80 PER PERSON
*BASIC KICKING AND SNAPPING SKILLS
REQUIRED*
HOUCHENS-SMITH STADIUM
BOWLING GREEN, KY
june 9: collins hs
801 discovery blvd
shelbyville, ky 40065
june 13: gallatin hs
700 dan p herron drive
gallatin, tn 37066
june 14: mccracken co. hs
6530 new highway 60 west
paducah, ky 42001
2016 CAMP APPLICATION
CA M PE R IN FOR M AT ION
FIRST NAME ________________________
LAST NAME ________________________
BIRTHDATE ________________________
AGE _________ T-SHIRT SIZE __________
HEIGHT__________ WEIGHT___________
GRADE FALL ‘16 _____________________
ADDRESS __________________________
________________________________
CITY _____________________________
STATE ____________________________
STUDENTS ENTERING GRADES 9-12
ZIP ______________________________
CAMP WILL RUN 5:00 PM-8:00 PM
(LOCAL TIME)
NAME OF SCHOOL ___________________
EMAIL ____________________________
STUDENTS ENTERING GRADES 9-12
TWITTER __________________________
CAMP WILL RUN 9:00 AM-3:00 PM CST
HOME PHONE _______________________
KICKERS, PUNTERS, & LONG-SNAPPERS
MOBILE PHONE ______________________
FUTURE TOPPER
YOUTH CAMP
MONDAY, JUNE 6 - WEDNESDAY, JUNE 8
$75 PER PERSON
HOUCHENS-SMITH STADIUM
BOWLING GREEN, KY
STUDENTS ENTERING GRADES 1-8
CAMP WILL RUN 9:00 AM-11:30AM CST
EACH DAY
PARENTS E-MAIL _____________________
POSITION__________________________
MAIL TO:
WKU FOOTBALL
HOUCHENS-SMITH STADIUM
1605 AVENUE OF CHAMPIONS
BOWLING GREEN, KY 42101
FAXED APPLICATIONS MAILED WITHOUT PAYMENT WILL NOT BE
ACCEPTED. PLEASE SEND APPLICATION ALONG WITH PAYMENT NO
LATER THAN ONE WEEK PRIOR TO EACH CAMP SESSION.
MAKE CHECKS PAYABLE TO WESTERN KENTUCKY UNIVERSITY