Speed Camp USA

Held at

Blossom Athletic Center

936-273-9821 phone/fax
When you feel the need for Speed
Free t-shirt for all paid-in-full registrants
Adult t-shirt size (circle): S M L XL XXL

Name:________________________________
Address:_______________________________

2017 Lineman Camp

City:_________________St:___ Zip:________

6th - 8th Grades

Phone#:__________________Grade:________

$75

Parents Name:__________________________
Cell#:__________________School:_________
Insurance Co __________________________________

Email:_____________________________.com
(for confirmation purposes; exclusive to Speed Camp USA)

Credit Card Information:

Check One: MasterCard Visa Discover
Card #_ _ _ _-_ _ _ _- _ _ _ _-_ _ _ _
Amt $_____________Exp(mo./yr.)____/____
CVV# ___ ___ ___ ZipCode______________

Speed & Agility Training

Stance & Starts & Down Blocking
Drive Blocking & Reach Blocking
Drills-Technique Training
Competition
Saturday, April 22nd @ 8 9:30am
Saturday, April 29th @ 8 9:30am
Saturday, May 6th @ 8 9:30am
Saturday, May 13th @ 8 9:30am
Saturday, May 20th @ 8 9:30am

Auth. Signature________________________

Check Information:
Check#____________Amt $______________
Make payable to: Speed Camp USA

No refunds after Apr. 22nd

Due to our competitive pricing & fixed cost structure,
there are absolutely NO PRORATES available.

RELEASE OF LIABILITY (waiver)

I
give
permission
for
_______________________________________________ to participate
in this 2017 event conducted by Speed Camp USA. I understand that I
must provide insurance coverage for my child and acknowledge that
Speed Camp USA and any agent involved with Speed Camp USA shall
be held harmless in the event of injury. I further understand that the
school insurance does not cover this event.
SIGNATURE FOR RELEASE OF LIABILITY

Parent

Date___/____/2017

www.SpeedCampUSA.com
Mail To: Speed Camp USA
P.O. Box 591691, San Antonio, TX 78259

Register Online or by Mail or Fax