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OFFICIAL APPLICATION TO ENROLL PAY ONLINE OR SEND $175 TO:
Mike Alstott Football Camp
c/o David Ross |
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Camper Name: _____________________________________________________________________________ Address:__________________________________________________________________________________ City:________________________________________________ State:__________ ZIP:__________________ Age:__________ Grade (Fall ’10):__________ T-Shirt Size: ___YL ___S ___M ___L ___XL ___XXL Parent/Guardian Name:_______________________________________________________________________ Home Phone:________________________________ Work Phone: __________________________________ Cell Phone:__________________________________ E-Mail:_______________________________________ COST: $175 - June 24, 25, 26 (Thursday-Saturday) Method of Payment: ___Check ___Money Order
Make checks payable to: Mike Alstott Football Camp. . PLEASE CHECK ONE OFFENSIVE AND ONE DEFENSIVE POSITION: Offense: ____Quarterback ____Running Back ____Wide Receiver ____Tight End ____Offensive Line Defense: ____Linebacker ____Defensive Back ____Defensive End ____Defensive Tackle PARENTAL CONSENT I certify that my child has been examined by a physician and found to be in good health and able to compete in all camp activities without restriction. I authorize the Directors of the Mike Alstott Football Camp to act for me according to their best judgment in an emergency requiring medical attention.
Parent/Guardian Signature:_________________________________________________ Date:_____________ Where did you hear about our camp?____________________________________________________________ |
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