OB KNIGHTS Football Camp Registration Form

The Old Bridge Knights Football Camp Dates:

Tuesday July 5th 9:30am-12:30pm

Wednesday July 6th 9:30am-12:30pm

Thursday July 7th 9:30am-12:30pm

Rain Date: Friday July 8th, 9:30am-12:30pm

CAMP is Open to student -athletes Entering 1st through 8th Grades.

COST: $125 per player (Sibling Discount, $75 each additional child) Due July 2nd

Payment Options: Venmo @ Justin-Meyer-3377

Or Check Made Payable to: Justin Meyer

23 Twain Ave. Old Bridge, NJ

Questions or Concerns?

Email: jpmeyer25321@gmail.com

Cell: 732-598-7097

Sneakers, Turf Shoes or Rubber Cleats (No Metal)

The Old Bridge Knights Football Camp is NOT responsible for Covid-19 related issues. This is train at your own risk.

Bring Snacks and Drinks

Athlete Information

Athlete's Name

First NameLast Name

Birth Date

MonthDayYear

Grade

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Parent/Guardian Information

Name

First NameLast Name

Home Number

Area CodePhone Number

Cell Number

Area CodePhone Number

E-mail

Emergency Information

Emergency Contact's Name

First NameLast Name

Relationship

Phone Number

Area CodePhone Number

Alt. Phone Number

Area CodePhone Number

Does the athlete have any allergies, chronic illness, or medical conditions? If yes, please describe.

Is the athlete prescribed an inhaler? If yes, please explain any instructions.

Informed Consent and Acknowledgement

I hereby give my approval for my child’s participation in any and all activities prepared by the Old Bridge Knights Football Camp during the selected camp dates. In exchange for the participation of said child’s participation in the Old Bridge Knights Football Camp, I assume all risk and hazards incidental to the conduct of the activities, and release, absolve and hold harmless ALL instructors, Coaches, Administrators of the Old Bridge Knights Football Camp, and all its respective officers, agents, and representatives from any and all liability for injuries to said child arising out of traveling to, participating in, or returning from selected clinic sessions.

In case of injury to said child, I hereby waive all claims against the Old Bridge Knights Football Camp, including all coaches and affiliates, all participants, sponsoring agencies, advertisers, and, if applicable, owners and lessors of premises used to conduct the event. There is a risk of being injured that is inherent in all sports activities, including football. Some of these injuries include, but are not limited to, the risk of fractures, paralysis, or death.

Medical Release and Authorization

As Parent and/or Guardian of the named athlete, I hereby authorize the diagnosis and treatment by a qualified and licensed medical professional, of the minor child, in the event of a medical emergency, which in the opinion of the attending medical professional, requires immediate attention to prevent further endangerment of the minor’s life, physical disfigurement, physical impairment, or other undue pain, suffering or discomfort, if delayed.

Permission is hereby granted to the attending physician to proceed with any medical or minor surgical treatment, x-ray examination and immunizations for the named athlete. In the event of an emergency arising out of serious illness, the need for major surgery, or significant accidental injury, I understand that every attempt will be made by the attending physician to contact me in the most expeditious way possible. This authorization is granted only after a reasonable effort has been made to reach me.

Permission is also granted to the Old Bridge Knights Football Camp and its affiliates including Directors, Coaches, and Team Parents to provide the needed emergency treatment prior to the child’s admission to the medical facility.

Release authorized on the dates and/or duration of the registered season.

This release is authorized and executed of my own free will, with the sole purpose of authorizing medical treatment under emergency circumstances, for the protection of life and limb of the named minor child, in my absence.

Confirmation

BY ACKNOWLEDGING AND SIGNING BELOW, I AM DELIVERING AN ELECTRONIC SIGNATURE THAT WILL HAVE THE SAME EFFECT AS AN ORIGINAL MANUAL PAPER SIGNATURE. THE ELECTRONIC SIGNATURE WILL BE EQUALLY AS BINDING AS AN ORIGINAL MANUAL PAPER SIGNATURE.