OT Johnson`s BRAVE TOUGH Wrestling Camp @ UNC Pembroke

WAIVER STATEMENTS
All participants in OT Johnson’s Brave Tough
Wrestling Camp must have their own medical
coverage. The camp provides additional coverage
only after the camper’s insurance policy has been
utilized. Campers will not be allowed to participate in
camp activities unless the following information is
submitted and is signed by the parent and/or
guardian of the camper.
Camper’s Insurance Company:
LOCATION: OT Johnson’s Brave Tough Wrestling Camp will be held at UNC Pembroke in
the Jones Center Main Gym.
One University Drive
Pembroke, NC 28372
WHAT TO BRING: Three sets of work out
clothes per day, head gear, wrestling/running
shoes, water bottle, swimsuit, towels, linens/
sleeping bag, pillow, toiletries, shower shoes,
spending money.
OT Johnson’s
BRAVE TOUGH
Wrestling Camp @
UNC Pembroke
__________________________________
Company Phone: ___________________
Policy Number/ ID: __________________
I, the undersigned, hereby certify that I am the parent/
legal guardian of the camper named on the other side
of this form, and I give my consent for the camper to
participate in the 2016 OT Johnson’s Brave Tough
Wrestling Camp. I hereby grant permission to OT
Johnson’s Brave Tough Wrestling Camp staff to seek
and allow appropriate medical attention to be
administered to my camper in the event of an injury,
accident or illness. I am responsible for all expenses
pertaining to medical attention and treatment, except
for expenses covered by OT Johnson’s Brave Tough
Wrestling Camp’s additional medical coverage policy.
TYPICAL DAILY SCHEDULE:
(Subject To Change)
6-7am Intensive Camper Work Out
7:30-8:30am Breakfast
8:30am Commuter Drop off
9-11am Wrestling Session I
11:15am-12:45pm Lunch
1-1:45pm Activity (Pool)
3-5pm Wrestling Session II
5:15-630pm Dinner
7-9pm Wrestling Session III
9:15pm Commuter Pickup
11pm Lights Out!!
By signing below, I attest that the camper named on the
other side of this form is physically qualified to attend
OT Johnson’s Brave Tough Wrestling Camp.
Parent/Legal Guardian Name (Print):
_____________________________________________
Signature:_____________________________________
Date:_________________________________________
An additional waiver must be filled out and brought to
registration or emailed to [email protected].
FOR MORE INFORMATION
Phone: (910) 521-4116
Email: [email protected]
Web: TBA
TECHNIQUE CAMPS:
6/19 – 6/23
-Intensive
-Resident
-Intensive Commuter
TEAM: 6/18—6/20
-Per Person
-Commuter
Head Coach: OT Johnson has been on the
coaching staff for 10 seasons currently. He has
coached 15 wrestlers to NCAA AllAmerican status, as
well as UNCP’s first,
and only two National Champions.
DO YOU HAVE WHAT IT TAKES TO
BE BRAVE TOUGH?
Please Complete both sides of this form and mail it with a $50
(non-refundable) deposit to O.T. Johnson, PO Box 1510,
Pembroke, NC 28372. Make all checks payable to OT Johnson’s
Wrestling Camps. The balance will be due prior to registration if
paying with a credit card or at registration via cash, money order,
and checks. Check in is from 12-2:30pm, and check out is at
12pm.
Select one of the following 2016 camps:
Assistant
Coach:
Technique Camp: June 19-23
___ Resident: $325
Chris Notte is an
NJCAA National
Intensive Camp: June 19-23
Champion and
___Resident: $425
2x All-American.
___ Commuter: $225
___Commuter: $325
___ Little Braves Commuter Camp: June 20-22
Also BIGXII silver
(Ages 5-12) $100
and bronze
Team Camp: June 18-20
medalist and 2x
National qualifier. Coached UNCP’s first and
___ Resident : $250
only two National Champions with Coach
___ Commuter: $175
Camper Name:_____________________________
Johnson.
Address:__________________________________
Assistant Coach
City:_____________________________________
Rashaad Saunders
State:__________________Zip:________________
was a four year
Email:____________________________________
starter for UNCP
registering 51 wins
before making his
The UNCP wrestling team will also be available as assist in
the knowledge building of wrestling and mental toughness skills. Also great for camper attention!!
Phone:___________________________________
Emergency Contact:________________________
transition to
Emergency Phone:__________________________
assistant coach. He
Current School:____________________________
also won Greco-Roman All-American honors
at the University Nationals.
A low counselor to camper ratio allows for
an abundance of personal attention!!!
Grade:________Age:_________Weight:__________
Feaured Clinicians TBA
Roommate Preference:________________________
For all residents, there will be a $25 key deposit required at
registration that will be returned when camp is over.