MA Youth Football Camp Registration

Madison Academy Youth Football Camp

Our 2023 Youth Football Camp will take place June 26-27 and is open to players from 5 to 12 years old. The cost is $100. All campers will receive a camp T-shirt and enjoy a meet-and-greet with Madison Academy Head Football Coach Bob Godsey.
Player information
Name*

First NameLast Name
Date of birth*

MonthDayYear
Date
School name*
Grade during the 2023-24 school year*
Favorite position to play*
Tell us a little about the player's previous football experience.
T-shirt size*
Parent/guardian information
Name*

First NameLast Name
Relationship to player*
Email address*
example@example.com
Home address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Mobile phone*
Please enter a valid phone number.Format: (000) 000-0000.
Home phone*
Please enter a valid phone number.Format: (000) 000-0000.
Emergency contact

If different from parent info above
Name*

First NameLast Name
Relationship to player*
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Parental consent
As the child/dependent participant’s parent or guardian, I have actual knowledge and appreciate that there are risks of bodily injury, such as cuts, sprains, concussions, and broken bones from one’s participation in football camp activities, and hereby voluntarily consent to the participant’s participation in football camp activities and assume all risks of possible injury. I understand that the Grant Reynolds Football Camp and Madison Academy do not provide any medical, accident, or other insurance to protect my participant child/dependent.
I agree
Release of waivers of claims
In consideration of my child/dependent being permitted to attend and participate in football camp activities, I, for myself, my child/dependent, my heirs, and personal representatives, do hereby waive, release, and discharge forever any and all claims for damages for bodily injury or death or damage or loss of property, that I or my child/dependent may have or that may occur subsequent to me or to my child/dependent against the camp operators, its officers, employees, agents, volunteers, representatives; and in consideration of the camp being offered at its premises, and the Board of Directors of Madison Academy and its administration and employees, and agents (the “School”) arising from or attributable to my child/dependent’s attendance at and participation in football camp activities.
I agree
Medical statement and qualifications
Participation in the Grant Reynolds Football Camp involves activities that require my child/dependent to be in good health and not be under any physician-directed limitations or restrictions that would suggest participation in the camp would place my child/dependent at risk of injury, aggravation of an existing condition, or result in compromise of a health condition. Although this camp is non-contact, I understand and acknowledge that camp activities will place a physical demand on my/our child/dependent that involves risks, which may include, but are not limited to, injury and health risks such as falls, collisions, cuts, bruises, sprains/strains, broken bones, cardiovascular events, neck/spinal injuries, heart attacks, and other risks inherent in any strenuous athletic activity; outdoor risks such as weather, lightning, heat or cold, bites, stings, allergic reactions, dehydration, sunburn, and animals; risks
from others involved in the camp such as transmitted illnesses or others’ actions; and other risks beyond the control of the Grant Reynolds Football Camp and Madison Academy. Should my child /dependent have any physician-directed restrictions, limitations and/or require an accommodation, I describe the health/medical condition and/or restrictions/limitations as follows and understand that this may preclude my child/dependent from participating in the camp:
I agree

My Products*

Please enter your credit card details below to pay the $100 per child camp registration fee. If you prefer to pay by cash or check later, enter the coupon code CASH or CHECK and then hit Apply.

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Madison Academy Youth Football Camp

Player information

Parent/guardian information

Emergency contact

Credit Card