Rushville Republican

April 26, 2013

Lions Football Camp 2013

Rushville Republican

RUSHVILLE — Lions Football Camp 2013

CAMP TIME: 3:30 to 5 p.m. May 20-23

AGE GROUP: 1st -8th grade

COST: $20 per person and fee includes football training and camp T-shirt.

EQUIPMENT: Old football shoes or tennis shoes, socks, shorts and practice shirt.

CAMP STAFF: Lions varsity staff and football players

WHERE: Rush County Fair Grounds

Lions Football Camp Application


GRADE: (this school year)________________________________________________

ADDRESS: (city, state, zip)_______________________________________________

Shirt Size (check one - if in doubt order larger size)

Adult XXL ___     Adult XL ___  Adult L ___  Adult M ___ Adult S ___                     Youth L (14-16) ___  Youth M (10-12) ___

Height    _____________________        Weight_____________________________


I hereby authorize directors of the LIONS FOOTBALL CAMP to act for me according to their best judgment in any emergency requiring medical attention and I hereby waive and release the camp from any and all liability for injuries and illness incurred while at camp. I will be responsible for any medical charges in connection with attendance at camp.


Camper is covered by (insurance company)___________________________________

Policy Number__________________________________________________________

Home phone____________________________________________________________

Work/cell phone_________________________________________________________

Office use

Check no.        Amount        Date