Brunswick Football Junior High Skills and Drills Registration Form
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Skills and Drills Information
WHO:   Available to all current 6th, 7th and 8th graders interested in football

When:  Each Sunday morning from 10:00 AM- 11:00 AM on the following dates:
Feb. 9th Feb. 16th, Feb. 23, March 1st, March 8th and March 15th

Where:    Brunswick High School East Gym

COST:   FREE OF CHARGE !!!   NO COST !!!!

WHAT:  Coach Pinzone and the football staff are hosting the first ever junior high football skills and drills program.  Student-athletes are invited to come and participate in various football skills, drills and activities in a positive, welcoming environment.

-Student athletes will work on foot skills, speed and movement related to football in a station rotation style
-Student athletes will experience drills related to both offense and defense
-Students athletes will get a chance to be coached by varsity and junior coaches as well as high school varsity football players.
-Student athletes will experience guest speakers each week before drills
-Parents will be able to sit in bleachers in the top balcony

ITEMS TO BRING:  t-shirt, shorts, tennis shoes, bottled water / gatorade bottle  ---  NO T-shirt provided!  Athletes should wear the following t shirts EACH week:
6th graders:  GRAY T-SHIRT
7th graders:  WHITE T-SHIRT
8th graders:  BLUE T-SHIRT

Any questions please email Coach Pinzone at mpinzone@bcsoh.org


CHILD FIRST NAME *
CHILD LAST NAME *
Child Current Grade Level *
Required
Child preferred Football Position(s) *
Required
Home Address *
Child cell if applicable
Parent Name *
Parent Cell Phone Number *
Parent Email *
Emergency Medical Authorization Form
Purpose - To enable parents and guardians to authorize the provision of emergency treatment for children who become ill or injured while under school authority, when parents or guardians cannot be reached.
 
I am aware of the risks, hazards, and inherent dangers that may arise due to my child’s participation in camps offered by the Brunswick Board of Education. In consideration for being allowed to participate in the Brunswick Board of Education Camp(s), I hereby release, waive, and discharge Brunswick City Schools, the Brunswick Board of Education, its instructors, agents, and employees from every claim, liability, or demand of any kind sustained, whether caused by the negligence of the Brunswick Board of Education or otherwise. This release shall be binding upon any heirs, administrators, executors, and assigns of mine. I further agree to indemnify the Brunswick Board of Education from any loss, liability, damage, or cost it may incur due to my child’s participation in the Brunswick Board of Education Camp(s) activity in any way whether caused by the Brunswick Board of Education or otherwise.

In the event of illness or injury resulting or arising directly or indirectly at the Brunswick Board of Education Camp(s), I hereby give my consent and authorization for (1) the administration of emergency first aid care and treatment at the scene of an emergency by faculty, staff members, or volunteers of the Brunswick Board of Education or (2) the administration of any treatment deemed necessary by a licensed physician or dentist and (3) the transfer to any hospital reasonably accessible. This authorization is not intended to cover major surgery unless the medical opinions of two (2) licensed physicians or dentists, concurring in the necessity for such surgery, are obtained prior to the performance of such surgery. I further declare and warrant that I am covered by sufficient medical and dental insurance and that such insurance will remain in effect during my child’s participation in the Brunswick Board of Education Camp(s).
 
I understand that it is my responsibility to maintain health insurance coverage for my student while engaged in the Brunswick Board of Education Camp(s). I hereby release, discharge, and hold harmless the Brunswick Board of Education and its representatives from any and all medical and health-related expenses and/or claims, whether covered by insurance or not, that may be incurred by my child while participating in school sponsored activities.
 
If the participant is under the age of 18, his/her parent or legal guardian must agree to this document for the underage participant. I, the participant, parent and or legal guardian agree to this document. I have read and understand the provisions of this document.

Emergency Medical Authorization Form *
Required
Parental Consent and Publicity Waiver
I certify that my child has no injury that would limit his/her participation in camp. I hereby release, exonerate and discharge the camp and the employees from any injuries incurred in camp or on the way to camp. I have medical coverage and will be responsible for any medical or other charges related to his/her attendance at camp. I give my child permission to attend the Brunswick Board of Education Camp(s). I grant permission for the Brunswick Board of Education to take pictures and/or video of my child for promotional materials in print and on the web.

By my signature, I attest that my child(s) is able to participate in the program indicated. I have full knowledge of the risks involved. In consideration of acceptance of this registration, I waive any and all rights and claims for damages we may have against Brunswick City Schools and the Brunswick Board of Education, its staff, and individuals associated with the Camps and will hold them harmless for any and all injuries incurred.

I understand that the Brunswick Board of Education Camp(s), Brunswick City Schools, or anyone associated with the camp will not assume any responsibility for accidents, medical, dental, or other expenses incurred as a result of instruction. The camp staff reserves the right to send any applicant to a hospital for treatment. The parent/guardian will assume all responsibility.

If the participant is under the age of 18, his/her parent or legal guardian must agree to this document for the underage participant. I, the participant, parent and or legal guardian agree to this document. I have read and understand the provisions of this document.

Parental Consent and Publicity Waiver *
Required
Assumption of Risks Waiver
Please read the following information regarding terms and conditions of the Brunswick Board of Education Camp(s) assumption of risks waiver. Read this document completely before you agree to this document. Its effect is to release the Brunswick Board of Education from any liability resulting from your child’s participation in the Brunswick Board of Education Camp(s) and waives all claims for damages or losses against the Brunswick Board of Education.
 
In consideration of my being permitted to participate in the Brunswick Board of Education Camp(s) at Brunswick City Schools. My child exercise’s their own free choice to participate voluntarily, and promising to take due care during such participation, hereby release and discharge, indemnify and hold harmless Brunswick City Schools, the Brunswick Board of Education, and Brunswick City Schools the Brunswick Board of Education, and their members, officers, agents, employees, and any other persons or entities acting on behalf, and the successors and assigns for any and all of the aforementioned persons, and entities, against all claims, demands, and causes of action whatsoever, either in law or in equity, relating to injury, disability, death, or other harm, to persons or property of both, arising from my participation in and/or at the above listed activity.
 
I acknowledge that I have been informed of hazards and risks which may be associated with participation in the above-mentioned activity, I understand, accept and assume those hazards and risks, and waive all claims against the Brunswick Board of Education. I understand that I am solely responsible for any costs arising out of any bodily injury or property damage sustained through my participation in normal or unusual acts associated with the above-named activity. I have had sufficient time to review and seek an explanation of the provisions contained above, have carefully read them, understand them fully, and agree to be bound by them. After careful deliberation, I voluntarily give my consent and agree to this Release from Responsibility, and Assumption of Risk Waiver.
 
If the participant is under the age of 18, his/her parent or legal guardian must agree to this document for the underage participant. I, the participant, parent and or legal guardian agree to this document. I have read and understand the provisions of this document.

Assumption of Risks Waiver *
Required
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