Reggie Grant’s 5^th Annual

FOOTBALL CAMP

and

Academic Success Workshops

Learn from retired NFL players and other knowledgeable coaches.

FREE with pre-registration – space is limited so register early.

Dates: Saturday and Sunday, June 24 & 25, 2006,

8:00 am –2pm

Ages: 8 – 18 , Individual and Group instruction, Boys & Girls

Location: South Gate High School

3351 Firestone Blvd, South Gate, CA 90280

Coordinated by:

Reggie Grant former New York Jet

Supported by:

Los Angeles Chapter of the NFL Players Association (retired),

Los Angeles Chapter of the National Alliance of African American Athletes

and South Gate High School.

Reggie Grant’s

Football Camp 2006 and Academic Success Workshop

REGISTRATION FORM and RELEASE OF LIABILITY FORM

(Please Print Clearly

First name: ____________________________ Last name ______________________

Age __________ Date of Birth __________/______/_______

Offensive Position ____________________ Defensive Position ___________________

GPA: _______ Favorite Subject: ___________________________________________

Team / School: ___________________________ Coach ________________________

Address ___________________________________________

City ______________________ St ___ Zip ________ Phone ( ) ________________

Emergency Phone ( ) _____________ Contact Name: _______________________

I realize every precaution is taken to eliminate any injuries or hazards, and a competent supervisor is present; however, in the event of any injury, I hereby waive, release and hold harmless from any liability for damages for personal injury including accidental death, as well as from claims for property damage which may arise in connection with the above named activity, against the supervisor, Reginald Grant, South Gate High School, the LA Chapter of the NFL Players Association, the National Alliance of African American Athletes, Reggie Grant’s Football Camp 2006, its officers, agents, employees and volunteers,. I further permit the use of activity/event photography and/or video for media promotion. In case of accident or other emergency, personnel of the event and/or its agents are hereby authorized to secure medical care deemed necessary as a result of accident or injury for the participant. I further agree to pay any and all costs incurred as a result of said treatment.

Adult/Guardian Name: __________________________

Signature: ____________________________________ Date: _________

Address : __________________________________ Zip ________ Phone( ) _______________

Mail this form and all donations to:

R Grant

Ref: 2006 Football Camp

P.O. Box 15602

Los Angeles, CA 90015

(213) 742-6523

We run this camp free of charge to pre-registered participants. All funds raised go to make this camp a success and cover such cost as insurance, facility rental, food, beverages, giveaways, etc. Your donations and support are appreciated as it cost us several thousand dollars to run this event. So, if its $25.00, $100. 00 or a $ 1,000.00 it is appreciated.

Make All Checks payable to:

R. Grant

P.O. Box 15602

Los Angeles, CA 90015

Afrogolf.com

Photo Gallery | Organizations | Jr. Golf | Features | Index

HOME

AfroGolf™ is the property of Reginald Grant