EVENTS TLC
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Indicates required field
Athlete's Name
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First
Last
Birthdate
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High School Graduation Year
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School or Youth Organization
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Athlete Position
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Trainer Request
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Jerry Flora
Jay Fiedler
PARENT/GUARDIAN INFORMATION
Parent or Guardian Name
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First
Last
Parent/Guardian Phone
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Parent/Guardian Address
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Line 2
City
State
Zip Code
Country
Parent/ Guardian Email
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Health info & waivers
I acknowledge that the above listed athlete is healthy and has been cleared by a physician to participate in physical activity consistent with football training. I hereby authorize Prime Time Sports Camps Inc., and Jerry Flora to act for the above listed athlete according to their best judgment in an emergency situation, and hereby waive and release Prime Time Sports Camps Inc., Jerry Flora its staff and the facility from any and all liability for injuries while at the clinic. I understand that accident insurance is provided, but health insurance is not.
Health Insurance Company
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Insurance Policy #
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EVENTS TLC - a Tournament Logistics & Coordination Company
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