GRIND Academy

Participant Name *

First

Last

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Home Phone *

Parent Phone *

Parent E-mail *

Participant Birth Date *

Age (As of July 13, 2023) *

Height

Weight *

High School Currently Attending

T-Shirt Size

Preffered Offensive Line Position

Medical Conditions/Injuries/Allergies *

Emergency Contact Name *

First

Last

Emergency Contact Phone Number *

I hereby give my child permission to participate in the 2023 Jermon Bushrod GRIND Academy. I realize football is a challenging sport and inherently has a possibility of injury. I understand that medical insurance is advisable, and the payment for any medical emergency, hospital, or physician treatment rendered for my child is my responsibility. I will not hold FOCUS Performance, or camp coaching staff liable in case of accident or injury.

I agree to the Parental Consent And Waiver Of Participation

I Agree

Participants need to wear shorts, athletic socks, cleats, (or appropriate footwear), and supporter (optional). Shirts will be provided for the participants.

Signature of Parent/Legal Guardian

Camp Payment

Price: $ 250.00

Stripe Credit Card *

Card

Name on Card