Camp Registration

Wallkill Valley
Camper Name:
Football Camp
Address:
2010
Home Phone:

Camper Age: Grade:  Price includes: camp T-shirt and

three days of instruction from
Camper School: camp clinicians

Allergies, Medications, or Medical Problems:  What to Bring: Football

shoes/cleats, sneakers, and a
WINNING ATTITUDE!

Primary Physician:  Lunch: Bring a bag lunch the first

two days of camp. Hotdogs and



Phone Number: snacks will be provided the last
day.
Position:

Offense: QB RB WR OL
 Beverages and Ice Pops will be
provided daily courtesy of the
Defense: LB DB DL Wallkill Valley HS Football
Program
T-Shirt Size:
 In the case of rain/thunderstorms
Youth: Medium Large the camp will be held inside the
gymnasium.
Adult: Small Medium Large X-Large

Parent/Guardian Information: June 28 – 30

Name:
2010
Phone:

Emergency Contact:

Contact Phone:
 Available to players ages 7-15
Camp Staff
Camp Director – Daryl Jones
 Currently entering his third year as
the Head Coach of the Wallkill
Valley High School Football Team
 15 years of coaching experience on
both the high school and college
level
 2008 NJ Herald Coach of the Year
WR’s/DL – Todd Van Orden
 Former Head Coach of WVRHS and
Hopatcong High School
QB’s – Bob Jones
 Former Head Coach at Butler High
School with over 40 years of
coaching experience and six State
Championships
RB’s/LB’s – Kevin Lukich
 Graduate of WVRHS and Moravian
College who is a current assistant
on the WVRHS staff
OL/DL – Adam Vasquez
 Graduate of Vernon H.S. and
Ursinus College and is currently an
assistant on the WVRHS staff
Scott Leiter - Certified Athletic Trainer
Camp Information
Dates: June 28-30 (Monday-
Wednesday)
Fees: $75.00 Individual or $125.00 per
Family (Mail-In by June 15th)
Late Registration (Day of Camp)
$80.00 Individual/$135.00 (Family)
Make checks payable to Daryl
Jones (Send payment in full or pay
upon arrival at 8:15am on June 28th)
Location: Wallkill Valley High School
(Call school for directions: 973-827-
4100)
Times: 9:00am– 3:00pm (Registration
8:15)
A certified athletic trainer will be onsite
during all three days of camp
CAMP ACTIVITIES:
 Station Drills/Individual
Instruction
 Position Instruction
 Agility and Speed Training
 7 ON 7 Competition
TEAR HERE
PLEASE DETATCH AND MAIL
TO THE ADDRESS
LISTED BELOW (FILL OUT
BOTH SIDES)
WAIVER: My child has permission to attend
the Wallkill Valley Football Camp. In the
event of an illness or injury, I give permission
to the Wallkill Valley Football Camp Staff to
secure appropriate emergency medical
treatment, and shall be responsible for any
charges incurred for such treatment. I
acknowledge that my child will be
participating in a contact sport and
specifically release the Wallkill Valley
Football Camp and all its staff and personnel
from any claim resulting from injuries/medical
conditions that he may sustain from camp.
Parent/Guardian Signature:
Date:
Mail to: Daryl Jones
Wallkill Valley High School
10 Grumm Road
Hamburg, NJ 07419
Questions
201-841-3021
coachjoneswv@gmail.com