PITTSFORD PRIDE JV/MOD A FOOTBALL CAMPS
2017 Dates
Pride Summer Camp 1 June 26th -29th Time: 5:00PM-8:00PM @ Mendon Stadium Field
Pride Summer Camp 2 July 17th -20st Time: 5:00PM - 8:00PM @ Mendon Stadium Field
Pride Summer Camp 3 August 7th-10th Time: 5:00PM- 8:00PM @ Mendon Stadium Field
For All Football Players Entering Grades 8th, 9th and 10th for Fall 2017
School Equipment: Uppers (Shoulder Pads/ Helmets)
Cost:$70 Per Camp or $190 Covers ALL 3 Camps
50% fee reduction for 2nd child and any additional players in family
Player – Helmet/Shoulder Pad Fitting: Monday June 26th 4-5PM, July 17th 4-5PM, or August 7th 4-5PM
Any questions or for payment assistance please call Coach Molinich 737-1480 or
Registration Form and Payment due no later than Monday June 26th
Name:______Grade:______
Address:______
Email:______Home Ph:______
Parents Names:______Emergency Ph:______
Make checks payable to PITTSFORD PRIDE FOOTBALL CAMPS
Mail to: 13 East Jefferson Rd Pittsford NY 14534
PLEASE READ THE FOLLOWING: Disclaimer of liability:
As a condition of enrollment this disclaimer of liability must be signed and dated by the camper and parents. It should be noted that this event is sponsored by the Pittsford
Pride Football Camp. The Pittsford Pride Football Camp is not affiliated with Pittsford Central Schools or Pittsford Athletics. It is understood that Pittsford Pride Football
Camp is not responsible for accidents resulting in medical, dental, or other expenses including loss of personal items. As legal guardian of the above participant, I grant permission to provide emergency treatment if necessary.
Our medical insurance carrier is______and policy number ______.
The above participant and his family assume the risk of injury while participating, therefore, releasing Pittsford Pride Football Camp, camp staff, camp coordinator , camp proprietor, as well as the Pittsford Central School district from all liability. It is understood that campers and his parents assume full responsibilities for any damages or injuries that may occur to the campers during or in route to any events sponsored by the Pittsford Pride Football Camp. These responsibilities fully and forever exonerate and discharge Pittsford Pride camp, camp staff, camp coordinator , camp proprietor, and Pittsford Central School district from any claims, demands, damages, rights of action, cause of action, present or future whether the same to be known, anticipated, or unanticipated, resulting from or arising out of the campers participation in the camp and on the use of the facilities.
Signature of the parent/Guardian______Date:______
Signature of the student______Date:______