Medical/Registration Form

Below you will find the Medical Release Form and The Registration form.

Both Forms Must be Filled out.

Participant's Information

First Name:

Middle Name:

Last Name:

Address:

City:

State:

Zip Code:

Date of Birth:

Insurance Information

Insurance Name:
	(Ex: Blue Cross/Blue Shield, Humana)

Type:
	(HMO, PPO, Military)

Primary Card Holder:

ID/Policy # :

Group/ Network # :

Verification #:
	(Ex....1-800)

Medical Information

Medical conditions/concerns
	(Ex....Asthma...)

Allergies to food, pollen, medicine, etc

Current Medications:

I acknowledge that the participants immunizations are current:

Yes
No

Emergency Contact Information

Name (not parent/guardian):

Relation to Participant:

	Street Address, City and State Please
Address:

Emergency Contacts Phone Numbers:

Home:

Work:

Cell:

Consent to Receive Treatment

Participants name:

plans to attend the Odell James Football Camp (OJFC). I fully understand that injury or illness could result from or during participation in the OJFC. In case of accident or illness, I give my permission to receive medical treatment as deemed necessary by the sports medicine staff. I will assume all responsibility for any medical bills.

Adult Participant or Parent/Guardians Name:

Please Print

Adult Participant or Parent/Guardians Signature:

Date:

2012 Odell James Football Camp (OJFC)

Registration Form

Both Forms Must be Filled out

Athlete's Full Name:

Athletes Street Address:

City:

State:

Zip code:

Area Code/Home Phone Number(s):

Parent's Name:

Cell Phone:

Email Address:

Any home information different from athlete's:

School:

Grade as of upcoming Fall

Position:

Quarterback
Running Back
Wide Receiver
Tight End
Offensive Lineman
Defensive Lineman
Linebacker
Defensive Back
Kicker/Punter

Yrs. played position:

Height:

Weight:

40 time:

Vertical Jump:

T-shirt size (choose one):

YS
YM
YL
Adult Small
Adult Medium
Adult Large
X-Large
XX-Large
XXX-Large

Please check one:

Underclassmen Camp Grades 3-6 Commuter $175
Underclassmen Camp Grades 3-6 Overnight $225
Upperclassmen Camp Grades 7-12 Commuter $200
Upperclassmen Camp Grades 10-12 Overnight $250

There is a nonrefundable fee of $75 for commuters and $100 for overnight campers

Meals and Housing

Overnight campers will reside on the Baylor campus in Allen Hall. Breakfast and lunch are served buffet style at Allen. Dinner will be catered and served at the stadium each night. Commuters are served lunch and dinner. Roommates will be randomly assigned prior to check in. Baylor University charges a $25 key replacement fee.

Air or Bus Travel

Campers traveling to Waco by air or bus should plan to arrive by noon on the first day of camp and depart after 1:00 p.m. on the last day of camp. Transportation to and from the airport or bus station will be provided by camp staff upon request. Please send a copy of the travel itinerary at least two weeks prior to the first day of camp.

What to Bring:

Tennis shoes
Athletic supporters
Athletic socks
Football cleats
Mouthpiece
Gym bag
Linens (sheets, blankets, pillow)
Towels
Personal items
Summer clothing
Money for incidentals (camp gear, fun snacks, etc.)

Make money orders payable to: O&K Sports, Inc./ 204 Edinburgh Ln./Woodway, TX 76712

Check with your tax professional about child-care expense write-offs, our federal tax ID # is 20-4765349