"Battle of the Trenches" Big Man Camp

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PLAYER INFORMATION

* First Name:

* Last Name:

* Street:

* City:

* State:

* Zip Code:

* Cell Phone:

* Birthdate:

* Email:

PARENT/GUARDIAN Information

* First Name:

* Last Name:

* Email:

* Cell Phone:

MEDICAL/EMERGENCY CONTACT INFORMATION

* Emergency Contact:

* Phone:

Insurance Carrier:

Policy #:

Complete PayPal upon form completion or:

One Week: Make check for $80 payable to:
Damascus Athletic Network

*All funds non-refundable after June 1st, 2014

Send to:
Attn: Battle of the Trenches
11830 Vineyard Path
New Market, MD 21774

WAIVER INFORMATION

My child has permission to attend the "Battle of the Trenches" Big Man Camp. I will notify the directors of the Camp if my child is on medication or is restricted in any way from participating in all activities. In the event of any emergency in which my child requires medical care, I authorize the Lineman Camp staff to act for me and obtain whatever medical treatment the staff, in its best judgment, deems necessary and appropriate. I specifically consent such treatment including but not limited to hospitalization and surgery and will be responsible for any medical or other charges in connection with attendance at the Camp. I acknowledge that at the Camp my child will participate in a sport that may involve, among other physical activities, physical contact of the body with other persons or objects, including the ground. I understand that at the Camp my child will incur a risk of injury. I specifically waive, give up and release the "Battle of the Trenches" camp, its directors, employees and anyone on the premises on which the Camp is held from liability for any claims or damages which I or my child may have for injuries or illness that may be sustained at the Camp.

I/we agree with the above *

* T Shirt Size:

* Damascus High School Session:

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