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Roosevelt High School
Youth Football Camp
Grades 5th-8th
July 6, 7, 8 and 9 (10am -1pm)
Fee $100.00
Join Roosevelt High School Head Football
Coach Matt Nelsen, RHS assistant coaches
and current RHS players for an exciting week of football.
Players will learn strength and conditioning techniques,
develop/improve football skills and
have fun in a positive environment. Non-contact
Registration form attached
Please send registration with payment by check to
8034 Forest Dr. NE, Seattle WA 98115
Checks made to Roosevelt High School
Email questions to :
Shannon Bloedel- shannonbloedel@gmail.com
Camp Check in-July 6th 2015 9:45am
Roosevelt High School Football Field
This camp is being held to benefit the Roosevelt Football
Team and has been approved by Roosevelt High School.
ROOSEVELT YOUTH FOOTBALL CAMP
2015
Location-Roosevelt High School
JULY 6TH-JULY 9TH 2015
COST
$100.00
Join Roosevelt High School Head Football Coach Matt Nelsen, Roosevelt assistant coaches and current
Roosevelt players. Players will learn strength and conditioning techniques, develop/improve football
skills and have fun in a positive environment. Non-contact
REGISTRATION
NAME
ADDRESS
CITY
STATE
ZIP
Payment: Make checks payable to Roosevelt High School Football $100.00 and send to: 8034 Forest Dr. NE
Seattle, WA 98115
T-SHIRT SIZE (ADULT) S
M
L
XL
XXL
PARENT INFORMATION
PARENT NAME
PARENT EMAIL
PARENT CELL
PARENT NAME
PARENT EMAIL
PARENT CELL
Parent Permission and Release:
We, undersigned parent or guardian, grant permission for our child to participate in the Roosevelt High School
Youth Football Camp. In exchange for this opportunity, we (player and parent) hereby release and discharge
forever all instructors and representatives of this camp, from any damages arising from any and all injuries while
participating in this camp. Roosevelt High School Football Camp does not assume responsibility for any injuries.
We further state that we have no knowledge of any impairment that would limit or preclude this child from
participating in this camp.
CAMPERS SIGNATURE
PARENT SIGNATURE
DATE
DATE
This camp is being held to benefit the Roosevelt Football Team and has been approved by Roosevelt High School.
ROOSEVELT YOUTH FOOTBALL CAMP 2015
MEDICAL RELEASE
I verify that (camper name) ________________________________________ has insurance which effectively
covers any medical cost incurred as a result of participation in the Roosevelt Youth Football Camp. Further, I
authorize the Coaching Staff at the Roosevelt Youth Football Camp to seek any necessary emergency medical
treatment my child may need during the course of camp.
Insurance Company Name: _______________________________________
Policy Number: _________________________________________________
Front and back copy of insurance card is required to participate in camp activities. Please include with
registration.
_____________________________________
Parent/Guardian Signature
______________
Date
_____________________________________
Parent/Guardian Printed Name
This camp is being held to benefit the Roosevelt Football Team and has been approved by Roosevelt High School.