2019 Brent Qvale Regional Football Camp
Camper's First Name *
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Camper's Last Name *
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Camper's E-mail Address *
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Home Address *
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City *
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State *
Zip *
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Camper's Phone # *
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Age *
Camper's age the day of the camp
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Camper's School Name *
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Grade in Fall 2019 *
Practice Jersey # *
Filming will occur during the camp which can be used for highlights video for the camper. Including the jersey will help to identify the camper.
Your answer
Practice Jersery Color(s) *
Filming will occur during the camp which can be used for highlights video for the camper. Including the jersey color(s) will help to identify the camper.
Your answer
T-Shirt Size *
Guardian's Name *
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Guardian's Phone# *
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Guardian's E-mail *
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Insurance Company *
Your answer
Policy Holder *
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Policy Number *
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Does the camper have any medical conditions coaches should be aware of? *
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