Welcome to the Quarterback Combine Summer Camp 2009!

Summer Camp 2010

REGISTRATION FOR CAMP

Mandatory Medical Waiver

Please download and fill oput
the medical waiver above,
sign and bring a copy!

Summer Mini Combines are geared for all athletes High School and
Youth to fine tune their skills before they enter the 2010/2011
football season. Four Sessions in a 2 weekend period gives the
coaches the time needed to run the repetitions needed for
preparation. 7 on 7 will be a major part of the schedule. Getting the
athlete in game situations, footwork, reading defenses and all his
skills and mechanics work.

SUMMER 1	SUMMER 2	SUMMER 3
8:00 am - 12:00 pm June 26 & June 27 $375.00 Location: Beverly Hills High School	8:00 am - 12:00 pm July 10 & July 11 $375.00 Location: Beverly Hills High School	8:00 am - 12:00 pm July 24 & July 25 $375.00 Location: Beverly Hills High School

SUMMER CAMP 2010 REGISTRATION

Athletes name:

Athletes School:

Athletes DOB:

Athletes Grade:

Athletes Position:

Athletes School:

Select Camp:

Each Camp - $375.00

PARENT INFORMATION

Parent Name:

Address:

City:

State:

Parent email address:

Home phone number:

Cell:

Referred by:

PAYMENT OPTIONS

Master Card

Visa

American Express

Check

Expiration date:

CARD SECURITY CODE:

Credit card number

Name: as appears on card:

Address:

City:

State:

Zip code:

AGREEMENT: This agreement shall be binding upon both parties and or any responsible party. QB
Combine accepts credit cards, money orders, checks or cash. Clients will be charged a $75.00 return
check fee and possible cancellation of the athlete to attend the combine. It is agreed that the Client
or responsible party for the Client will carry his own insurance. Parents release, hold harmless and
waive any and all responsibility of the QB Combine/TOPGUN Combine, any and all facilities used,
the staff or city in regards to the athlete in any way. This agreement constitutes the entire
understanding between the parties. A waiver of breach of any provisions and acknowledgements of
the rules of this agreement shall not be construed as a continuing waiver of other breaches of the
same or other provisions hereof. This agreement shall be governed by the laws of the State of
California. The total information input on this form from the athlete and the responsible party for
the athlete give authorization for the Client named above to participate in all aspects of the
sessions of the QB Combine/ TOP GUN Combine. It is agreed that the client or the responsible
party of the client acknowledges and agrees to all conditions of the Medical Waiver. Photos and
video taken of the Combine and athletes are the sole ownership of the Quarterback Combine which
is authorized to use for their web site or promotions.

Submitting online agrees to all conditions. (NO REFUNDS).
By submitting on line, constitutes my signature and authorization to the agreement stated, all
provisions and authorization for the Quarterback Combine to charge the credit card information
input for training fees selected. Discounts will be deducted automatically before the credit card
information is processed.
We accept: MASTER CARD, VISA & American Express
3% Credit card process fee will be added

Mandatory Medical Waiver

Medical waiver must be signed and submitted.

I have read and agree to the above terms: