REGISTRATION FORM

NAME ______

Address: ______

Zip: ______Phone:______

Parents Name: ______

GRADE (Entering in Fall 2015)______

OFFENSIVE POSITION ______

DEFENSIVE POSITION ______

MEDICAL INFORMATION COACHES SHOULD BE AWARE OF ______

______

______

INSURANE COMPANY______

SUBSCRIBER NAME______


SUBSCRIBER ID#______

PLAN #______GROUP#______

I verify that my child has been checked by a licensed physician and is physically able to participate in this football camp. I agree to allow my child to be treated by a licensed physician if necessary and to assume all costs related to such treatment. I authorize the disclosure of medical information to my insurance for the purpose of claim. I understand that if this application is accepted there is no refund of the fee unless we can fill the spot. I hereby waive and release the Penfield Youth Football Camp, Staff and Penfield Schools from any and all liability for any injuries incurred by my child while attending camp.

Parent Signature ______

SHIRT SIZE _____ YL _____YM _____ YL _____YXL (ADULT SIZES) ____S ______M ______L ______XL

MAKE CHECKS PAYABLE TO :

PENFIELD FOOTBALL BOOSTER CLUB

FOR OFFICE USE ONLY
PAYMENT TYPE: CASH ______CHECK (#) ______

Typical CAmp schedule


12:00 Stretch/ Form run

12:10 Agilities

12:20 WATER BREAK

12:25 OFFENSIVE STATIONS

1:05 WATER BREAK

1:10 DEFENSIVE STATIONS

1:40 WATER BREAK

1:45 TEAM ACTIVITY

1:55 CLOSING

2015

PENFIELD YOUTH FOOTBALL CAMP

For students entering

GRADES 1-5
JULY 20-23 (MON-THURS)

TIME 12:00-2:00pm

PENFIELD HIGH SCHOOL

COST $60.00

cAMP philosophy

This camp will be tailored for athletes participating in the AYFCL and Pop Warner Youth Football programs. Emphasis will be on providing each participant with football fundamentals as well as specialty skills.

CAMP STAFF

GREG GEESLER

HEAD FOOTBALL COACH

penfielD High SChool

camp director

TERRY LLOYD

ASSISTANT FOOTBALL COACH

PENFIELD HIGH SCHOOL

PHIL LAPIETRA

ASSISTANT FOOTBALL COACH

PENFIELD HIGH SCHOOL

STEVE FLAGLER

ASSISTANT FOOTBALL COACH

PENFIELD HIGH SCHOOL

OTHER PENFIELD HIGH SCHOOL ASSISTANT COACHES AND VARSITY PLAYERS and YOUTH COACHES WILL BE ON HAND TO ENSURE MAXIMUM PARTICIPATION THROUGH A LOW PLAYER TO COACH RATIO

Areas of Instruction

Each Athlete will learn multiple offensive and defensive positions

Quarterbacks: proper throwing

technique, stance, dropping back, play action, sprint out passing, ball handling, and reading defenses.

Receivers: ball handling, stance,

receiving techniques, route running, and reading coverage.

Running Backs: ball handling,

stance, run and pass blocking, pass receiving, and reading blocks

Offensive Lineman: stance, starts, run and pass blocking, pulling, and trapping.

Defensive Line: stance, alignment, key reads, pass rush, run and pass defense, pursuit and tackling.

Linebackers and Secondary:

alignment, stance, proper position, pass coverage, pursuit and tackling

Participants should wear shorts,

t-shirt, sneakers, and bring A “labeled” water bottle. Drills will be

“passive” contact. Mouth guards and

cleats are strongly recommended, but are not required.

SESSIONS WILL RUN FROM 12:00-2:00

WHERE: PENFIELD HIGH SCHOOL

COST: $60.00

MAKE CHECKS PAYABLE TO:

PENFIELD FOOTBALL BOOSTER CLUB

REGISTRATION:

REGISTRATION CAN BE DONE BY FILLING OUT REGISTRATION FORM AND MAILING TO

Attn: COACH GREG GEESLER

PEnfield YouTH FOOTBALL CAMP

231 HEDGEGARTH DRIVE

ROCHESTER, NY 14617

MAIL IN REGISTRATION BY: TUESDAY, JULY 15th

*- ALL ATHLETES WiLL receive A CAMP TEE-SHIRT

LATE REGISTRATION:

MONDAY, JULY 20th FROM 11:30-12:00

* CASH ONLY

LATE REGISTRATION DOES NOT a GUARANTEE A CAMP T-SHIRT

eligibility:

ALL INTERESTED ATHLETES

ENTERING GRADES 1-5 IN FALL 2015.