Pope Lacrosse

“Dirty Dog” Skills and Drills Camp

June 11, 12, and 13, 2013Pope High School

U-9 and Up

The skills and drills camp will focus on building fundamental skills using drills that focus on maximizing the number of touches players get during each drill.

Players will receive a Dirty Dog reversible jersey and a camp T-shirt in addition to three days of outstanding instruction by the Pope High School Coaching Staff as well as some of Pope’s finest current and former players.

The Camp will run from 8:30 – 12:30 each day. Players should bring all their lacrosse equipment and appropriate shoes as well as a water bottle or sports drinks and snack each day. The cost of the camp is $125.

Please fill out and return the registration form and waiver on the next two pages and mail them with your check made out to Pope Lacrosse Booster Club to:

Attn: Coach Carl Pfaff

Pope High School

3001 Hembree Rd.

Marietta, GA 30062

For questions regarding the camp, please contact Carl Pfaff ()

404-409-2482

Registration Form

Dirty Dog Skills and Drills

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Please have your registration in by May 1 to secure your position at camp.

Name ______Position______

Age ______Experience ______

Address ______

City ______

Phone ______parent cell______

Parent e-mail______

T-shirt Youth S M L XL Adult S M L XL

Reversible size S/M L/XL ADULT ONLY SIZES ON REVERSIBLES

Pope Lacrosse Skills and DrillsCAMP

3001 Hembree Rd. NE. MariettaGa.30062

MEDICAL RELEASE -

Player Name ______

Please list any medical conditions we should know about.

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What medications, if any, do you take on a daily basis?

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Please list any allergies.

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MEDICAL TREATMENT: We being the legal guardian(s) of the applicant, authorize Pope Lacrosse and its agents permission to request medical treatment as is necessary to insure the well being of our dependent(s).

Medical Information:

Immediate Emergency Contact Phone Number: ______

PARENT’S RELEASE:

In signing this application, I release Pope Lacrosse, PopeHigh School, CobbCountySchools and other involved parties from any claims or responsibility for injuries suffered at this camp. I knowingly assume all risks associated with participation, even if arising from the negligence of the participants or others, and assume full responsibility for my child's participation. I certify that my child is in good physical condition and has my full permission to participate in a vigorous lacrosse camp. Furthermore,I authorize the Camp

Director to request medical treatment as necessary to insure my child's well-being.

CONSENT OF PARENT OR GUARDIAN

I, THE UNDERSIGNED, being the parent or guardian of ______, do hereby grant permission for his participation in all activities, athletic or otherwise, sponsored by Pope Lacrosse, and release from responsibility said corporation for any injuries sustained by him or expenses incurred there from, while engaged in any activity of the Pope Lacrosse Skills and Drills camp.

Insurance CompanyPolicy Number

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Printed name______Date______

Signed ______Date______