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Bradley Central High School

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2008 Bear Kid's Football Camp Registration

Please read and sign:

I hereby authorize any medical treatment which may be advised or recommended by the attending Bradley Central High School Sports Camp staff. I acknowledge and understand that by participating in this camp the possibility does exist that my son/daughter may sustain physical injury/illness (minimal, serious, catastrophic) in connection with activities of camp. I indemnify and hold harmless Bradley Central High School as well as its representatives from any claim for personal illness or injury that my son/daughter may sustain during the camp.

NAME AND POLICY NUMBER OF YOUR INSURANCE

_________________________________________________________________

CAMPER'S NAME: __________________________________________________

ADDRESS: ________________________________________________________

CITY, STATE, ZIP : __________________________________________________

AGE _________ GRADE (08-09): __________ T-SHIRT SIZE ___________

PARENT'S FULL NAME: _____________________________________________

TELEPHONE NUMBERS WHERE YOU CAN BE REACHED DURING CAMP HOURS IN CASE OF EMERGENCY:

__________________/ ________________/ _______________HOME/WORK/CELL

PLEASE GIVE ALTERNATIVE NUMBER AND CONTACT PERSON:

NAME: __________________________ PHONE: _________________________

Please list ANY special needs whether personal or medical that your child may need or that we need to be aware of:

______________________________________________________________________________

PARENT

SIGNATURE: ___________________________ DATE: ___________________

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A tradition since 1916!

BRADLEY FOOTBALL

Bradley Central High School

1000 South Lee Highway, Cleveland, Tennessee 37311