2014 boys football camps - Southeast Missouri State University

One University Plaza MS 0200
Cape Girardeau, MO 63701
GoSoutheast.com
2014 BOYS FOOTBALL CAMPS
Kids Camp
Boys entering grades 2-8
June 26-27, 2014
REDHAWKS FOOTBALL KIDS CAMP
Thursday, June 26-Friday, June 27
Day One: Check-in at 9 a.m., check-out at 6 p.m.
Day Two: Check-in at 8:30 a.m., check-out at 4 p.m.
Head Coach Tom Matukewicz
Tom Matukewicz was introduced as the new
head football coach at Southeast Missouri
State University on Dec. 18, 2013. He has
17 years of coaching experience, including
12 seasons as a coordinator. His teams have
participated in postseason play 10 of the last
11 seasons. Matukewicz spent the last two
years as defensive coordinator and linebackers
coach at the University of Toledo. To see
more of Matukewicz accomplishments, visit
GoSoutheast.com.
Learn football fundamentals and skills from Southeast Missouri State Redhawks coaches
and student-athletes. Emphasis will be placed on teaching the proper techniques
to maximize safety.
Campers will receive a free camp t-shirt. Campers should bring work-out clothes, cleats
and a water bottle.
Cost:
$95 for commuter campers. Camper will receive lunch and dinner on day one and lunch
on day two.
$125 for resident campers. Camper will stay overnight in air-conditioned residence halls
at Southeast Missouri State University and will receive lunch and dinner on day one as
well as breakfast and lunch on day two.
For additional information about Southeast football camps and clinics, visit
GoSoutheast.com/camps, or contact Matt Martin at (620) 481-4499 or
[email protected].
REGISTRATION
Last Name
First Name
As a parent or legal guardian of _______________________, I do hereby
authorize, consent, and request Health Services personnel and/or the athletic Training
Staff to provide preliminary evaluation of illnesses and to conduct first aid treatment of
potentially serious injuries for my child/legal ward. I understand that no further treatment
will be given without contacting me, except for life-threatening situations.
Middle Initial
Address
Signature
City/State/Zip
Camper Mobile Number Contact Phone Number
Email (All camp info and confirmations will be sent via email)
Grade Entering
Date of Birth
School Attending
Adult Shirt Size (S,M,L,XL)
(includes three meals)
Relationship
Home Phone (___)
Day Phone (___)
Cell Phone (___)
I further authorize that my child/ward may receive Tylenol, Pepto Bismol or Maalox while
attending this camp. Signature
In case of emergency and parent cannot be reached at above numbers, contact:
Name
Relationship
Day Phone (___)
Please Check Desired Camper Status
Commuter Camper, $95
Date
Resident Camper, $125
(Includes overnight housing and four
meals)
Priority Registration is due by May 23, 2014.
Please register for your camps early to help our staff plan for an optimized camp
experience. Cancellations prior to two weeks before start of camp will be fully
refunded. Please provide medical documentation for cancellations less than two
weeks prior to the start of camp.
Cell Phone (___)
Insurance Co.
Policy No.
Group No.
Known allergies or other conditions:
Amount $
MasterCard
Visa
Discover
Acct#
Verification# (3 or 4 digit number)
Check Enclosed
Exp. Date
Signature
Mail completed form and payment to: Southeast Missouri State University/Boys Basketball
Camp Director, One University Plaza MS 0200, Cape Girardeau, MO 63701