Make Checks Payable to:
Maximum Athletic Performance Camp
Please Return Checks and Applications to:
Bryan McGovern
Head Strength and Conditioning Coach
Events Center
Binghamton University
PO Box 6000
Binghamton, NY 13902
2006 CAMP APPLICATION
Name:
Address:
Sport(s) that you play:
Parent/Guardian:
Home Phone #:
Emergency Contact:
Emergency Phone #:
E-Mail Address:
Date of Last Physical:
Insurance Provider:
Insurance Policy #:
Please check the box of which camp you will be attending and fill out the following information
SENIOR CAMP
Please place a 1 in your first time preference and a 2 in your second time preference.
Session I (9:00 am – 10:15 am)
Session II (10:30 am – 11:45 am)
Session III (4:00-5:15)
If you select 3, 4 or 5 weeks, please indicate the dates the camper will be attending
3 weeks Dates:
4 weeks Dates:
5 weeks Dates:
6 weeks
Age and Grade entering in fall
T-Shirt size (circle one) S M L XL
JUNIOR CAMP
(Wednesdays and Fridays June 28th – August 4th 9:00 am to 10:00 am)
If you select 3, 4 or 5 weeks, please indicate the dates the camper will be attending
3 weeks Dates:
4 weeks Dates:
5 weeks Dates:
6 weeks
Age and Grade entering in fall
T-Shirt size (circle one) S M L XL
Note: Any serious violation of camp regulations (damage to school property, disrespect to any coaches or other campers or any other behavior deemed a detriment to the camp) will result in the immediate dismissal of the camper. If a camper withdraws from the camp, there will be NO refund
MEDICAL CONDITIONS:
Please list any physical condition that the camp should be aware of:
RELEASE:
I understand that my child is engaging in a physical fitness program, which may include exercises to build the heart and lungs, muscle endurance, strength and flexibility, and improve body composition. Exercises may include, but not limited to, aerobic activities, calisthenics, weight lifting to improve muscular strength and endurance, and flexibility exercises to improve joint range of motion. I understand that participation in this program is at the campers risk, and at no time will I hold Binghamton University or the Director of this camp liable for any injuries that might occur during workout sessions, or on any later date. I will be responsible for all medical charges in connection with my child’s attendance at the Maximum Athletic Performance Camp. I also give my permission for the Athletic Trainer to address any illness or injury that may occur while the child is at the Maximum Athletic Performance Camp.
Parent/Guardian Signature:
Date:
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