2022 Bulldog Field Hockey Camp
Complete the online registration. Pay on MySchoolBucks (link below) or mail your check/cash to Westfield OR bring it on the first day of camp.
Checks are made payable to WABC for $150.00
Mail checks/payment to:
Westfield High School
Activities Office: Field Hockey Camp
4700 Stonecroft Blvd.
Chantilly, VA 20151

Questions? Email Danielle Barthold - dgbarthold@fcps.edu 
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Camp flier page 1/2
Camp flier page 2/2
First Name of Camper *
Last Name of Camper *
School attending for Fall 2022 *
Grade level for Fall 2022 *
Player Cell # (if applicable)
Email address of player (if applicable)
Address *
City *
State *
Zip Code *
Parent Name *
Parent Cell # *
Email address of parent *
Preferred position *
Skill level *
Emergency Contact - Name and Number *
T-Shirt size (adult) *
Code of Conduct (parent/guardian: typing your name and date qualifies as your signature). I will not engage in unsportsmanlike conduct with any coach, parent, player, participant, official, or any other attendee and will treat them with respect at all times. I will not engage in any behavior that would endanger the health, safety, or well-being of any coach, parent, player, participant, official, or any other attendee. I will not use profanity or any other offensive or aggressive language even if it is not directed at a particular person. MEDICAL/LIABILITY RELEASE I, the undersigned parent/guardian, do hereby give permission to any emergency x-ray examination, anesthetic, medical or surgical diagnosis or treatment and hospital care, which is deemed advisable by, and is to be rendered under the general or special supervision of, any physician and surgeon licensed under the provisions of the Medical Practice Act. It is understood that this authorization is given in advance of any specific diagnosis, treatment, or hospital care being required. It is given to provide authority and power on the part of Westfield High School Field Hockey and anyone associated with the Bulldog Field Hockey Camp to give specific consent to any and all such diagnoses, treatment, or hospital care which the aforementioned physician in the exercise of her best judgement may deem advisable; and neither said agent or any organization involved assumes any financial responsibility for exercising this action. I realize that the sport of field hockey is potentially dangerous and involves considerable risk, including the possibility of broken bones, other internal injuries, or death. Therefore, I do hereby for myself, my heirs, executors, and administrators release Westfield High School Field Hockey, anyone associated with the Bulldog Field Hockey Camp and the facilities where games/tournaments are conducted from all claims, demands, actions, liability or causes of actions resulting from any injury to my child or my property or resulting of my, child's death, which my occur during participation in this sport. Parent/guardian type your name and date below *
Payment
Pay on MySchoolBucks (link below) or mail your check/cash to Westfield OR bring it on the first day of camp.

Checks are made payable to WABC for $150.00
Mail checks/payment to:
Westfield High School
Activities Office: Field Hockey Camp
4700 Stonecroft Blvd.
Chantilly, VA 20151
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