Josiah Cotton's ICE Football Camp Registration Form

Josiah Cotton's I.C.E. Football Camp Details:

LOCATION: 4659 Cavalier Dr, Macon, GA 31220

DATE: JUNE 28, 2025

CHECK IN: 8:00 AM - 9:00 AM

CAMP STARTS: 9:00 AM

LUNCH: 1:00 PM

CAMP ENDS: 3:00 PM

*All players are required to arrive properly dressed for camp (shorts, shoes, cleats, gloves)

*All players are to fill out and bring the Parental waiver and release form to camp.

Ages 6-18: 9:00 AM - 3:00 PM

CAMP : 9 AM - 1 PM

LUNCH: 1:00 PM to 1:45 PM

I.C.E. SESSION: 2:00- 3:00 PM

PICK-UP: 3PM

Athlete Information

Athlete's Name*

First NameLast Name

Birth Date*

MonthDayYear

MaleFemale

Group 1: Ages 6-11Group 2: Ages 12-18

What position do you play?*

T-Shirt size*

Any dietary restrictions.*

Parent/Guardian Emergency Contact Information

Name*

First NameLast Name

Emergency Phone #1*

Area CodePhone Number

Name*

First NameLast Name

Emergency Phone #2*

Area CodePhone Number

E-mail

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Informed Consent and Acknowledgement

I hereby give my approval for my child’s participation in any and all activities prepared by the Josiah Cotton's ICE Football Camp during the selected camp. In exchange for the acceptance of said child’s candidacy by the Josiah Cotton's I.C.E. Football Camp, I assume all risk and hazards incidental to the conduct of the activities, and release, absolve and hold harmless the Josiah Cotton's I.C.E. Football Camp, Eagle's Nest Foundation, all parties, constituents, volunteers, its respective coaches, trainers, and ALL representatives from any and all liability for injuries to said child arising out of traveling to, participating in, or returning from selected camp session, on said property location, to include parking lots, subsequent fields and any area to and beyond fenceline.

In case of injury to said child, I hereby waive all claims against the Josiah Cotton's I.C.E. Football Camp, Eagle's Nest Foundation, all parties, constituents, volunteers, its respective coaches, trainers, and ALL representatives from any and all liability for injuries to said 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.

I Agree

Confirmation

BY AGREEING ABOVE AND SUBMITTING THIS FORM, I AM DELIVERING AN ELECTRONIC SIGNATURE THAT IS EQUIVALENT TO AN ORIGINAL MANUAL PAPER SIGNATURE. THE ELECTRONIC SIGNATURE WILL BE EQUALLY AS BINDING AS AN ORIGINAL MANUAL PAPER SIGNATURE.

Josiah Cotton's ICE Football Camp

Additional Player Information