2019 JACKSON FOOTBALL YOUTH CAMP REGISTRATION
Each camper must have a separate form submitted.
Camp Days: June 3rd-6th, 2019
Time: 10 am - 12 pm
Location: Robert Fife Stadium, 7355 Mudbrook St NW, Massillon, OH 44646
Contact: Coach Larry Baker (330) 327-0906 or
Camper First Name
Camper Last Name
Contact Phone Number
Grade in 2019 Fall School Year
Please choose a shirt size (note: T-shirts are pre-ordered based off this registration form):
Emergency Contact Name
Emergency Contact Relationship to Camper
Emergency Contact Phone
This is to certify that my child (please choose from below) HAS or DOES NOT HAVE full medical insurance coverage through a family protection policy and I will assume responsibility for medical expenses that might occur during this JHS athletic event.
DOES HAVE FULL MEDICAL INSURANCE COVERAGE
DOES NOT HAVE FULL MEDICAL INSURANCE COVERAGE
A copy of your responses will be emailed to the address you provided.
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