Diggs Football Camp

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Individual Position/ Agility Training Registration

Athlete INFORMATION

* First Name:

* Last Name:

Street:

City:

State:

Zip Code:

Phone:

* Birthdate:

* Email:

Gender:

Team:

Position:

Hudl Link:

* Grade:

PARENT/GUARDIAN #1

* Firstname:

* Lastname:

* EMail:

Home Phone:

Work Phone:

* Cell Phone:

PARENT/GUARDIAN #2

Firstname:

Lastname:

Email:

Home Phone:

Work Phone:

Cell Phone:

MEDICAL/EMERGENCY CONTACT INFORMATION

* Emergency Contact:

* Phone:

* Relationship to Player:

* Insurance Carrier:

Policy #:

WAIVER INFORMATION

I, the undersigned parent/guardian of the above camper, do hereby grant the authority to the staff of Diggs Football Camp LLC to apply judgment regarding medical assistance in the event of an accident, injury, or illness if they are unable to contact the parent or guardian. I authorize first aid, a medical or surgical diagnosis and treatment which may deem necessary.
I, the undersigned, release Diggs Football Camp LLC and any of its coaches, staff, manager, and/or any parent for any responsibility in case of accident, illness, or injury during my child’s enrollment.

I/we agree with the above *

Signature:

Date:

* indicates required fields

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Individual Position/ Agility Training Registration