JUNIOR SPARTAN FOOTBALL CAMP

CAMP DETAILS
Jr. Spartan
Football Camp
All young men in Grades 5-8 (in Sept. 2015)
are invited to attend this camp to have fun,
learn new skills, and make new friends.
for Young Men
Grades 5-8
DATE:
June 29, June 30, July 1, 2015
June 29-July 1
9 am-12 noon
TIME:
9:00am - 12:00noon
LOCATION:
Immaculata High School
Somerville, NJ
COST: $25.00
Check payable to:
Immaculata High School
WHAT TO BRING:
Cleats, sneakers, water and snack
COACHING STAFF:
Immaculata H.S. Coaches
Current Immaculata H.S. Football Players
Current College Football Players
Special Guests
IMMACULATA
FOOTBALL
Tom Falato, Head Coach
www.immaculatahighschool.org . 908-722-0200
2015 Junior Spartan
Football Camp Registration
June 29, June 30, July 1 9:00am-12:00pm
PLEASE PRINT NEATLY & RETURN THIS SECTION WITH
YOUR REGISTRATION FEE
Student Name:__________________________________________
Student Date of Birth MONTH:___________YEAR:___________
Student Address: ________________________________________
City/State/Zip:__________________________________________
Home Phone:___________________________________________
Parent Name:___________________________________________
Parent Cell #:___________________________________________
Parent Email:___________________________________________
Student Grade Entering Sept. 2015:__________________________
Family Physician:________________________________________
Physician’s City:_________________________________________
Physician’s Phone #:______________________________________
Medical Insurance Carrier:_________________________________
Insurance Policy #:_______________________________________
In case of an emergency and parents cannot be reached during
hours of camp, Immaculata has been granted permission to contact:
Name:_________________________________________________
Relationship to camper:___________________________________
Phone #: _______________________________________________
List all medical conditions camp personnel should be aware of: (allergies, disabilities, chronic illnesses, etc.) ___________________
______________________________________________________
______________________________________________________
______________________________________________________
Other than any chronic or recurring medical or physical conditions
I have listed above, I hereby certify that my child is in good physical
health and may participate in all camp activities. I will not hold the
school or camp personnel responsible in the event of an accident or
injury as a result of his participation.
______________________________________________________
Signature of parent or guardian is required / Date
For Office Use Only:
Date Form & Payment Received:____________
Camp $25 Ck#_______ Cash:______
A certified athletic trainer is on duty
during all camp hours.
Questions?
Contact us at 908-722-0200 ext. 115
[email protected]
For additional sports camp information:
Please visit our website at
www.immaculatahighschool.org
Please mail registration form and full payment to:
Immaculata Athletic Office
240 Mountain Avenue
Somerville, NJ 08876
**A separate check is required for each camper.
**Please make checks payable to Immaculata.