2021 SCA FLAG FOOTBALL CAMP REGISTRATION FORM LAST NAME _________________ FIRST NAME ___________________
2021 SCA FLAG
Entering Grade: ______ @ _______________ Attending SCA: YES / NO Parent’s Name: _______________________________________________
FOOTBALL CAMP
Parent’s E-mail: ______________________________________________ Home Phone: ___________________ Emergency # : _______________ Address: ____________________________________________________ T- Shirt Size : YM YL S
M
L
XL
CAMP FEE (Pre-Registered by July 6th): $50
XXL (included in registration) Late Registration: $60
FAMILY PASS: $80 - (all campers must live in same household, +$10 if late after March 31st) Camp Release and Consent Form I, the parent or guardian of the child above, do release the Summit Christian Academy (SCA), its employees, and camp staff of any and all liability for medical expenses incurred while participating in the 2021 SCA Youth Football Camp. I am aware of my child’s health and believe my child to be physically able to participate in normal football related activities. If, in the case my child is injured during the camp and I cannot be reached, I give the SCA football camp staff full permission to seek appropriate medical attention as they see fit. ______________________________ __________________ Signature of parent/guardian Date SCA FAMILIES: CHARGE MY FACTS ACCT $_______ Initial ________ NON-SCA FAMILIES: Make check payable to: SCA (Flag football in memo line) Please drop off registration form by March31st at any school office (Elem/HS) or email/ mail form to: Todd Berck - League Director @ tberck@sca-kc.org Summit Christian Academy 1500 SW Jefferson Lee’s Summit, MO 64081
Students entering grades 1-8 Every Monday Evening 6pm - 8pm April 5th, 12th, 19th, 26th & May 3rd @SCA Football Practice Fields “Where Faith and Football Collide”