Athlete’s Name:_______________________________________________________

Address:_____________________________________________________________

City/State/Zip:_________________________________________________________

E-Mail:______________________________________________________________

Home Phone:_________________________________________________________

Father’s Name:_________________________work/cell:_______________________

Mother’s Name:________________________ work/cell:_______________________

Emergency Contact (other than above)_______________________Phone:__________

School:______________________Grade in September 2011:______Age:______

Medical Conditions, previous injuries, or allergies we should be aware of:
__________________________________________________________________

T-shirt size: YOUTH: L XL ADULT: S M L XL

How did you hear about Hardcore Sport Training Camps?
_________________________________________________________________________________________

I certify that my child has my permission to participate in Hardcore Sport Training Camps and/or Bill Redell/Bryan Howard Hardcore Sport Training Football Camps. I authorize and release the camp instructors/staff to act for me according to his/her best judgment in any emergency requiring medical attention. I hereby waive and release Oaks Christian School, Hardcore Sport Training Camps and/or Bill Redell/Bryan Howard Hardcore Sport Training Football Camps, Bill Redell, Bryan Howard and Staff from all liability for injury or illness incurred while at camp. I have no knowledge of any mental or physical impairment which could affect my child’s ability to participate in this camp, or any mental or physical problem that would be affected by the above child’s participation in the camp program, and according to our family physician, our child is fit to participate in all camp activities. I further certify that my child has medical insurance in case of an emergency. I also give my permission for my child to be given emergency treatment at a local hospital.
I have read the above regulations of the camp and agree to abide by them.

_______________________________________
Signature of parent/guardian

Please mail registration form to:

3600 Radcliffe Road
Thousand Oaks, CA 91360

Payment in full is due 10 days prior to first day of camp through on-line registration system.