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My son would like to enroll in the Rusty Kellum
Wrestling Camp. I understand that transportation will
not be provided. The $125.00 registration fee (payable to
Rusty Kellum) is enclosed.
Please Print
Full Name
Coach Kellum
7898 Capeside Way
Jacksonville, FL 32222
Application for Enrollment
Age_________ Birth date ________________
Address ______________________________
City ______________ State ___ Zip ________
Telephone ________________________
Entering Grade _____
School ____________________________
Circle shirt size:
Boy’s: Small
Men’s: Small
X-Large
Medium
Medium
Large
Large
Parent Signature
Please include your camp fee and mail your registration to the
address below. Campers may also register the day of camp
one hour before the start of camp, as space allows. Send
completed registrations to:
Rusty Kellum
7898 Capeside Way
Jacksonville, FL 32222
At
Bishop John J. Snyder
High School
Ages: 5 to 14
Time: 9:00-1:00
For more information call
Coach Kellum at 553-3212
or the school at 771-1029.
When: June 29-July 02
Welcome to the Rusty Kellum Wrestling Camp at
Bishop John J. Snyder High School. We are very excited to
have you as part of our summer camp.
During this week of camp you will learn the fundamentals of
wrestling—including the seven basics skills every wrestler
needs. In the mornings you will be taught the fundamentals
and the afternoons will be spent putting your new talents to
use during simulated matches.
Camp Director
Rusty Kellum
Coach Kellum was a wrestling coach for 23 years in
Jacksonville., both at Forrest High School and Bishop Snyder.
Our goal is to make this the most enjoyable week of the
summer for you and your children! We hope you can stay and
watch as much as possible this week.
You will learn a lot, work hard, and
most importantly, have a great
time on the mats!
Sincerely,
Coach Kellum
Camp Schedule
9:00-9:30
Stretching & Running
Drills
9:30-10:15 Individual Stations
10:15-10:25 Morning Break
10:25-11:10 Individual Stations
11:10-11:30 Morning Review
11:30-12:00 Lunch (provided)
12:00-1:00 Open Mats and Group Matches
*Thursday—matches will be held in the
morning and afternoon
Camp Cost
The entire cost for camp is $125.00. Each camper is
provided a camp T-shirt , lunch daily, and concessions
will also be available during the camp.
Camp Features
Lunch will be provided daily
Every camper gets a camp t-shirt
Fun activities and games each day
Parental Permission and
Release of Liability
The undersigned parent, guardian or legal representative hereby
consents to the participation of _______________ (name of
child) in Rusty Kellum’s Wrestling Camp and all of its associated
activities.
For and in consideration of the child being allowed to participate
in this camp and other valuable consideration, the undersigned
parent, guardian or legal representative on behalf of the child and
the child’s parents, personal representatives, assigns, heirs and
next of kin do hereby release and hold harmless the Diocese of
St. Augustine; a corporation sole; Bishop Felipe Estevez, individual; Bishop John J. Snyder, individual; Bishop John J. Snyder
High School, Rusty Kellum’s Wrestling Camp; all organizers of
this camp all volunteers, chaperones, employees, and agents of
the said parties; and their personal representatives or assigns
from any loss or damage on account of any injury to the personal
or the personal property of the child, or death caused by negligence or otherwise, while the said child is engaged in the abovestated camp and any activities of the camp.
The undersigned expressly agrees that this release waiver, and
indemnity agreement is intended to be as broad and inclusive as
permitted by the laws of the State of Florida and that if any portion of this agreement is held invalid, it is agreed that the balance
shall, notwithstanding, continue in full legal force and effect.
The undersigned parent, guardian or legal representative further
acknowledges that he/she is authorize to enter this agreement on
behalf of the child, the child’s parents, personal representatives,
assigns, heirs and next of kin.
I further authorize any representative of this camp to obtain
medical treatment or my child in the unlikely event of an injury
or illness during this program and I agree to pay any expenses
incurred for such treatment.
Parent
Guardian
Representative
__________________________________________________
(Signature)
DATE _________________________________
“Rusty Kellum’s Wrestling Camp is not affiliated or associated
with Bishop John J. Snyder High School, the Diocese of St.
Augustine, Bishop John J. Snyder or Bishop Felipe Estevez, as
Administrator of the Diocese of St. Augustine, corporation sole.”