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WHS FOOTBALL CAMP AGES 7-12

 
WHS Football Camp
Run by WHS Coaching Staff & Players
When: June 6th & 7th
Where: Emil Nasser Stadium
Times: 10am -12pm
Ages: 7-14
Price: $25.00
Child’s Name __________________________________________ Age _________
Parent/Guardian Name (printed) _________________________________________________Phone__________________
Alternate Emergency Contact _________________________Phone _________________

Please mail form to Winslow Football Club 600 E Cherry St Winslow, AZ 86047
You can also Register onsite starting at 930am, June 6th

Questions ?? bguzman@wusd1.org or 928-288-8100
CONSENT FOR MEDICAL TREATMENT OF A MINOR AND RELEASE OF RESPONSIBILITY
I, ____________________________ (full name of parent/guardian) declare that I am the parent/guardian of _____________________
(full name of minor). I hereby authorize the staff of the Winslow Bulldog Football team, located in the City of Winslow, County of Navajo, State of Arizona to consent to any x-ray examination, anesthetic, medical or surgical diagnosis or treatment, and hospital care necessitated by injury or illness while the above named child is attending the Winslow Bulldogs Football Camp. Such treatment is to be rendered to the minor under the general or special supervision and on the advice of a physician or surgeon licensed to practice in the state of Arizona. I hereby waive and release Winslow High School, parents and players, from any and all liability for injuries or illness incurred while at the camp, or while traveling to and from the camp.
I hereby certify that I have read and fully understand this authorization.

Date_______________ Signature_____________________________________________________

Attached Files