Small Group/Private Lesson Registration
- Please bring water or sport drink
- Students should wear T-shirts, Shorts, Socks, and Cleats
- If inclement weather…may need to reschedule (will be in contact)
CYG QB School Registration
______________________________________
Name
______________________________________
City, State, Zip
______________________________________
Phone No. and Parent E-mail
______________________________________
Parent/Guardian Signature
____________ ___________
Age Grade 2009-2010
___________________ _________
Organization Yrs of Exp.
Make Checks Payable to:
Carolina Young Guns QBS
Mail registration form, fee, and copy of current physical (for new students) to:
Carolina Young Guns QBS
c/o Rob Clark
920 Siena Drive
Wake Forest, NC 27587
The undersigning gives permission to _______________________________ (Student-Athlete Name)
to attend and participate in the CarolinaYoungGunsQuarterbackSchool. Enclosed is the registration fee.
A copy of a current/updated physical form signed by a physician MUST accompany this registration form (unless already on file). The physical must be current at the time of the QB School session. Students cannot participate without this documentation (NO EXCEPTIONS).I have no knowledge of any physical impairment that would affect or be affected by my son’s participation in this school. I acknowledge having insurance coverage should an injury occur. I agree to not hold Carolina Young Guns Quarterback School or any of the coaches or employees liable for any injuries should an accident occur. In the event of an emergency, in which my child needs medical care, I authorize the coaches/trainer to act for me and obtain any medical treatment deemed necessary and appropriate. Please attach a note explaining any special limitations and/or required medications.
____________________________ _____________________________
Parent/Guardian Signature Emergency Phone Number
________________________ ______________ ___________________
Insurance Co. Name Group # Policy Number
