2023 Tribe Pride Youth Camp

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This form can be used to register your child to attend our youth football camp to be held at the Lehighton Area Athletic Facilities on July 19-20, from 9-1130am.

Email *

Player Name: *

Address *

Parent/Guardian Phone *

Grade (at start of 2023-24 school year) *

Age (at time of the camp) *

Name of school

Shirt Size *

Youth Small

Youth Medium

Youth Large

Adult Small

Adult Medium

Adult Large

Adult XL

Adult 2XL

I certify that my child: _______________________________________has had a physical exam within the last year and is in sound physical condition for participation in Tribe PrideYouth Football Camp. Also, I authorize the staff of the Tribe Pride Youth Football camp to act accordingly and with their best judgment in an emergency situation. I have adequate insurance and hereby waive and release the Tribe Pride Youth Football Camp and it’s staff from any and all liability in the eventof injury or illness requiring treatment, hospitalization, and /or surgery. Tribe Pride Youth Football Camp is not responsible for and will not provide any medical, dental, hospital, or laboratory fees due to injury while participatingin the Tribe Pride Youth Football Camp. *

Any medical needs/concerns *

Emergency Contact Name & Contact Number *

Medical Insurance Company Name *

Medical Insurance Company Number *

Payment Option *

Check: Made out to Lehighton TD Club, Sent to Tribe Pride Camp, Lehighton Area HS, 1 Indian Ln, Lehighton, PA 18235

Venmo: @mccarroll3

Payment Amount *

$40 (if On or Before July 1)

$50 (if After July 1)

A copy of your responses will be emailed to the address you provided.

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