NE Elite Clinic Player Application

Document Sample
NE Elite Clinic Player Application Powered By Docstoc
					NE Elite Clinic Player Application
Name: _________________________________________________________ Address: _______________________________________________________ _______________________________________________________ School: ______________ Grade: ____ Phone: ___________________

Email (for receipt):___________________________________________ Release Form and Policies
The above participant has my permission to participate in the New England Football Clinic. I understand and accept the condition that neither the NE Camps, Inc., its directors or coaches or the site owner will assume responsibility for medical and dental expenses incurred as a result of participation in this clinic. I also confirm that the participant has personal medical insurance coverage and that any expenses incurred while at the clinic is my responsibility. In case of an emergency, I understand that every attempt will be made to contact the person listed. If contact is unsuccessful, I give permission to the attending medical personnel to render medical treatment to the participant.

Parent Signature____________________________________________________ Emergency Phone #_____________________________________________ Insurance Company & Policy #: __________________________________

Order Form
(Circle the clinic you wish to attend.) The Elite Package (for the serious player) (includes: 4 Day Clinic, Clinic T Shirt, Champion Practice Shirt And a Player Evaluation from Coaching Staff & Directors Or The Skills Package (for the team player) (includes: 4 Day Clinic, T Shirt) Optional: Equipment Rental (Helmet & Shoulder Pads) Champion Football Mesh Shorts- Circle Size: Adidas 100% Cotton Camp Shirt; Circle Size: S-M-L XL-XXL L-XL -XXL $250


$50 $25 $15

TOTAL (check payable to John Papas):


Mail to: NE Clinics, Inc. c/o John Papas, 259 Mt. Auburn St. Watertown, Ma 02472

Shared By:
Description: NE Elite Clinic Player Application