Bishop Amat High School Hit & Hustle Football Clinic 2012

1. Bishop Amat High School
Grades 3-8
Camp Director
Steve Hagerty
Head Football Coach,
$
75
Registration fee includes
Bishop Amat High School The Hit & Hustle Football Camp is a basic
skills camp put on by the Bishop Amat
football coaching staff, and is happening
on Friday and Saturday, June 22 -23, 2012.
On Friday the 22nd, the camp begins at 6
pm and dismisses at 9 pm. On Saturday
the 23rd, the camp resumes at 9 am
and concludes at 12 pm. The cost of the
camp is $75 and includes six hours of
Contact phone: 626-962-2495 ext. 6001 instruction, hot dog lunch, group photo,
or bahitandhustlefootballcamp@yahoo.com certificate of participation, camp t-shirt,
and two tickets to a football game for the
The football coaching staff, along with varsity players at 2012 season. If interested, contact Coach
Bishop Amat High School will be instructing at the camp Hagerty at 626-962-2495, ext. 6001, or
bahitandhustlefootballcamp@yahoo.com.
What to Bring...
// T-shirt & Shorts Part I: Friday, 6/22/12 6pm-9pm
// Cleats & Athletic Shoes
// Water Bottle (Optional) Part II: Saturday, 6/23/12 9am-12pm
Please complete registration form, enclose $75 check, detach and mail to:
Hit & Hustle Football Camp
c
/o Steve Hagerty
2820 Rhodelia Ave | Claremont, Ca 91711
Make checks payable to: Hit & Hustle Football Camp
Name ______________________________________________________________________________________ q Male q Female
Address ___________________________ City ____________________ Zip_________ Phone Number (_______)_______________
E-mail Address _____________________________________________ Current School ____________________________________
Grade ________ Age _______ T-Shirt size (circle one): XS S M L XL XXL
EMERGENCY CONTACT INFORMATION
Parents Name ______________________________________________ Emergency #______________________________________
Medical Insurance Carrier _____________________________________ Policy # __________________________________________
Other emergency contact _____________________________________ Phone # _________________________________________
Please list any medical conditions, limitations, or needs: _______________________________________________________________
__________________________________________________________________________________________________________
I hereby authorize the director, staff, and volunteers of the Hit & Hustle Football Camp to act for me according to their best judgement in any
emergency medical situation. I hereby waive, release, exonerate, and discharge the Archdiocese of Los Angeles, Bishop Amat High School, and the
Hit & Hustle Football Camp Staff and all its volunters from any and all actions or causes known or unkown, from any injuries incurred in camp, or
on the way to and/or from camp. Costs for treatment of injuries and hospitalization for illness or injuries incurred during the Hit & Hustle Football
Camp will be the responsibility of the parent or guardian of the participant. I certify that my child is healthy, and has no injury or illness which
would limit his participation.
Parent Signature ___________________________________________ Date __________________