Download 2017 Bear`s Athletic Training/ Sports Medicine Camp

Registration Form
Participant’s name:__________________________
Address:___________________________________
City:________________ State:_____ Zip:_________
T-shirt Size:
XS
S
M
L
XL
XXL
Parent’s Name:_____________________________
Home phone( )_____________________________
Students apply every taping/wrapping
Cell phone( ) ______________________________
techniques they learned on some of the
Email:_____________________________________
2017 Bear’s
Athletic
Training/
Sports
Medicine Camp
camp leaders!
Missouri State University
Springfield, MO
June 7-10, 2017
Emergency contact name and number:
__________________________________________
Grade for school year 2016-2017:_____________
Name of School:____________________________
Camper type: Resident
or
Commuter
Camp Level: Level One or
Level Two
Gender:
Female
Male
or
Parent’s Release & Indemnity Agreement
We (or) I hereby request you accept the application for enrollment of ______________ in the
2017 Bear’s Athletic Training/Sports Medicine (AT/SM) Camp during the dates set forth in this
Students say goodbye to their new friends
and hello to what could be a new piece of
their future!
application, and in consideration of your acceptance of the application, we (or I) (whether one
or more) hereby release the Bear’s AT/SM Camp and the Board of Governors of MSU and all
their employees and agents from all claims on account of any injuries which may be sustained
by our (or my) minor child while attending the 2017 Bear’s AT/SM Camp and its employees and
agents for any claim which may hereafter be presented by our (or my) minor child as a result of
such injuries. I (or we) authorize and provide consent for licensed medical providers or MSU
Taylor Health Center physicians and staff to administer any medical procedure or treatment
which may be deemed medically advisable by the attending physician including diagnostic
testing and examination should my child become injured or sick during the camp.
Parent’s/Legal Guardian Signature:_______________
For more information:
Visit our website:
http://sportsmed.missouristate.edu.
Or Call
417-836-8553 (phone)
Registration Information
Camp Highlights

One-on-one instruction in
taping and wrapping
techniques
To secure your spot, please return registration form (on
back) by May 24th. Late registration will be accepted
based space availability.
Registration Options


The Bear’s Athletic Training/Sports Medicine
Experience life on
the MSU campus
Residents: Individual will stay on-campus in a residential
hall and all meals will be provided.
Most affordable AT camp
around
Cost $275 ($300 after May 24 if late registration is
available).
Commuter: individual will come to campus daily for
camp activities, lunch will be provided.
Camp is designed for high school students who
are interested in gaining basic athletic training
 Behind the scenes
tours of the athletic
facilities on and off
campus.
knowledge and skills. Camp participants will
have the opportunity to work along side
nationally certified and Missouri licensed
athletic trainers and meet current MSU
 Additional topics
covered include: wound
care, injury prevention,
common injuries,
concussions, heat illnesses, environmental
concerns, performance enhancement, and much
more.
athletic training students and athletes.
Cost $200 ($225 after May 24 if late registration is
available).
Camp Level
Level One: Students attending camp for the first time
Level Two: Students returning to advance their skills
All Participants receive

Camp t-shirt

Lunch (breakfast and dinner for residents)

A great education and a lot of fun!
Send Registration to

Athletic Training Olympics - time to show off your
skills in a head to head competition
Send completed form (on back) to:
Missouri State University
901 S National Ave, PROF 160
Springfield, MO 65897
Or fax to 417-836-8554
For more information call or email:
417-836-8553 or [email protected]