BLUE CHIP FOOTBALL 2008 REGISTRATION FORM print  |  close window        Last Name:     First Name:   Street Address:   City:    State:    Zip:   Age (as of 7/9/08):    Grade (Fall '08):     School You Will Attend in the Fall of 2008:           Home Phone:    Emergency Contact (Name):   Alternate Phone (Cell):    Emergency Phone Number:   Position(s) / Please Circle:       QB      Receiver/Back    Defensive Back      Line  Shirt Size / Please Circle:     S     M     L     XL    XXL    XXXL Any Restrictions on Participation?       My son has permission to attend Blue Chip Camp. Enclosed is a $25 non-refundable reservation fee (or full payment). This will be applied to the tuition, balance of which will be paid prior to camp. In the event of illness or injury I hereby give my consent for medical treatment and permission to the attending physician to hospitalize, secure proper treatment and order injections, anethesia or surgery. I will be responsible for any medical or other charges in connection with his attendance at camp.     CANCELLATIONS:  Written or emailed cancellations must be received no later than two weeks prior to the first day of camp (Deadline: June 23, 2008), in order to receive a refund. Refunds will be mailed in full less the $25 deposit/administrative fee.     Parent's Signature:        He is Covered By (Name of Insurance Company):        Policy No.            Send Application (and make checks payable) to:   Blue Chip Camp, 33283 Harbor Reach Drive, Lewes, DE 19958