Gridiron Skills Camp

GRIDIRONSTAT.COM Summer Skills Camp June 2023

Registration Form
All camp sessions will be held at Waggoner Road Junior High, 360 S Waggoner Rd, Reynoldsburg, OH 43068

Week 1 (7-10 year olds)

June 5 - June 10 (Monday – Saturday)

*Campers should arrive at 9:30.

10:00 am – 12:00 pm

Fee:$180.00

Week 2 (11-15 year olds)

June 12 – June 17 (Monday – Saturday)

*Campers should arrive at 9:30.

10:00 am – 12:00 pm

Fee:$180.00
Camper Name

First NameLast Name
Address

Street Address

CityState / Province

Postal / Zip Code
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Camper Email
example@example.com
Parent/ Guardian Name

First NameLast Name
Parent/Guardian Email (for initial confirmation)
example@example.com
Emergency Contact Name (other than parent/guardian)
(Emergency) Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Medical issues, daily medications, special needs
Date of Birth
School
Grade (as of next fall)
Graduation Year
Age
Height
Weight
Adult Shirt Size
Youth Shirt Size
Preferred Position
*CHOOSE ONE POSITION* You may change upon arrival at camp
Camp Session

Camp Fee

$180.00

Enter coupon

Total

As a participant in the above program, I recognize and acknowledge that there are certain risks of physical injury. I agree to assume the full risk of any injuries, damages or loss which I or my child may sustain as a result of such participation. I further understand that the Gridiron Stat LLC does not provide accidental medical coverage and it is my responsibility to provide appropriate coverage. I agree to waive and relinquish all claims and hold harmless the Gridiron Stat LLC, its officers, agents, and employees from any and all claims.
Signature (Parent/Guardian)
Date

MonthDayYear
Date
Should be Empty:

GRIDIRONSTAT.COM Summer Skills Camp June 2023