Deer Creek Middle School Football Camp & Summer Pride Registration
Please return enrollment form and payment to Coach Pense by Friday, May 15. Forms may be
dropped off at the middle school office or mailed to: DCMS, Attn: Marc Pense, 2601 NW 234th,
Edmond, 73025. Enrollments will be accepted up to the starting dates but no t-shirt will be
ordered for late enrollments. Please pay with Cash. Any student entering 6-8 grades is eligible
for camp and summer pride. Camp will be at the middle school football field and pride is at
the high school weight room. Shorts, t-shirt, and tennis shoes or cleats need to be worn. No
pads are needed for football camp. Bring water.
Name__________________________________
2015-2016 Grade______________
Address________________________________
Phone_________________________________
My student-athlete _________________________________ has my permission to
participate in the:
Please indicate by circling: Deer Creek Middle School Football Camp
May 27-29, 9:00-11:30 am
Summer Pride Program (6 week program)
June 8-July 16, 9:15-10:30 am
Monday –Thursday only, No Fridays
F/B camp cost: $75 (Cash only please)
Summer Pride cost: $130 (Cash only please)
Camp and Pride cost includes t-shirt.
No refunds will be given for camp or pride.
I understand that my son will participate in activities that may involve physical contact with other persons and objects.
I understand that there is no insurance carried by the school, and I specifically waive and give up and release the
instructors and school from liability for any claim or financial responsibility for damages which my son may have for
injuries or illnesses that he may sustain at or traveling to and from the school. In the event of an emergency in which
my son requires medical attention, I authorize the staff to act for me and to obtain whatever medical treatment that the
staff may deem necessary. I further agree to be responsible for any medical or other charges in conjunction with his
participation at the school. If your son has any restriction or medical conditions please list them below.
Please note any medical conditions:__________________________________
Parent Signature:_____________________________________Date:_______________
Emergency Phone #_____________________________________
Please circle adult T-shirt size:
Sm.
Med.
Large
If you have any questions contact Marc Pense at marcpense@dcsok.org.
XL
XXL