2021 Anthony Becht Football Camp Bonner/Prendergast

Camper Information

• * First Name:
• * Last Name:
• * Grade (Fall of '21):
• *

  Shirt Size:

  • Youth M
  • Youth L
  • Youth XL
  • Adult S
  • Adult M
  • Adult L
• School:

Additional Campers

You may add a maximum of 3

Parent Information

• * First Name:
• * Last Name:
• * Email Address:
• * Confirm Email Address:
• * Address 1:
• * City:
• * State: --Choose-- Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming -------------- Alberta British Columbia Manitoba New Brunswick Newfoundland and Labrador Northwest Territories Nova Scotia Nunavut Ontario Prince Edward Island Quebec Saskatchewan Yukon Territory
• * ZIP Code:
• * Cell Phone:

• Promo Code

  Enter Code: Apply

• Fee

  Type	Fee
  Event fee	$165.00

Parent Consent, Acknowledgement and Release Form

• (A) I/WE HEREBY GIVE CONSENT FOR MY CHILD TO PARTICIPATE IN THE 2021 ANTHONY BECHT FOOTBALL CAMP.

• (B) I/WE KNOW OF AND ACKNOWLEDGE THAT MY CHILD KNOWS THE RISKS INVOLVED IN PARTICIPATION IN SUCH A CAMP AND UNDERSTAND THAT SERIOUS INJURY AND EVEN DEATH IS POSSIBLE IN SUCH PARTICIPATION.

• (C) I/WE CHOOSE TO ACCEPT ANY AND ALL RESPONSIBILITY FOR HIS SAFETY AND WELFARE WHILE PARTICIPATING. WITH FULL UNDERSTANDING OF THE RISKS INVOLVED.

• (D) I/WE RELEASE AND HOLD HARMLESS MY SCHOOL, THE SCHOOLS INVOLVED, ANTHONY BECHT, ANTHONY BECHT FOOTBALL CAMP LLC, ANY COACH OR PROFESSIONAL PLAYER AND TRAINER, ALSO...

• AS WELL AS ANYONE INVOLVED IN THE ADMINISTRATION OF THIS CAMP OF ANY AND ALL RESPONSIBILITY AND LIABILITY FOR ANY INJURY OR CLAIM RESULTING FROM PARTICIPATION.

• (E) I/WE AGREE TO TAKE NO LEGAL ACTION AGAINST ANY OF THE ABOVE BECAUSE OF ANY ACCIDENTS OR MISHAP’S INVOLVING THE PARTICIPATION OF MY CHILD.

• *

  I HAVE READ THIS CAREFULLY AND KNOW IT CONTAINS A RELEASE:

  • YES
  • NO
• * Insurance Company:
• * Policy Number: