______________________________ The 2009 It is necessary that our doctor has parents’ permission to administer treatment in the event The Distinguished Coaches that might Quarterback of an accident or sudden illness. coach the camp are: Receiver Name ________________________________ ______________________________ Academy Antonio Smikle Date of last tetanus immunization __________ Hofstra Running Backs Coach _________________________ Camp Director List any conditions that physicians should be AT HOFSTRA UNIVERSITY aware of: _____________________________ Dave Patenaude _________________________________________ _____________________________________ Hofstra Quarterbacks Coach Assistant Camp Director Emergency contacts: 1) _________________ Phone ____________ Kahmal Roy 2) _________________ Phone ____________ Hofstra Wide Receivers Coach Adam Hollis I hereby authorize any medical treatment Princeton which may be advised or recommended by the attending physician of ______________ T.J. Moriarty (student name) while at Hofstra University. Wagner Insurance Coverage for accidental injury is Chris Roark required by all participants. In most instances, Trinity Saturday-Sunday, June 27-28 family health is adequate. Mike O’Connor A highly intense two day camp 9 I have the required insurance Bucknell dedicated to the development of the 9 I do not have the required insurance fundamental skills and techniques of Devale Ellis Quarterback & Receiver play. Insurance Company _____________________ Detroit Lions Policy # ______________________________ Shane Smith ROOM IS LIMITED, New York Jets FIRST COME, FIRST SERVE _____________________________________ (Signature of Parent/Guardian) For more information, call 516-463-6709 ______________________________________________ _____________________________________ QUARTERBACK RECEIVER ACADEMY AT What Will A Quarterback Learn From This Camp? Why Should I attend HOFSTRA UNIVERSITY ______________________________________________ The QB/Receiver Academy _____________________________________________ Quarterbacks will learn the fundamentals and proper _____________________________________ mechanics of throwing the football. There are a few positions that are so dependent on each Please make check payable to other for success. A perfect relationship between a Quarterbacks will learn the proper fundamentals of Perry11 Football Camp, INC. quarterback and his receiver is a necessary ingredient to center/quarterback exchange, drops, reset mechanics, and include check with form to: an effective passing attack. At the Academy, a establishing a proper throwing platform, sprint-out, dash Quarterback Receiver Academy commitment exists to develop the skills and techniques mechanics and scrambling techniques. Football Office required at both position. It is the philosophy of the 147 Hofstra University Camp that this can best be achieved only through Quarterbacks will learn to recognize basic pass defenses as 208 Stadium Building discipline and hard work. well as common reads and “trigger”drills that quarterbacks Hempstead, NY 11549 need to effectively attack basic coverages. Quarterback and Receiver cannot develop fully exclusive 9 Quarterback 9 Wide Receiver Quarterbacks will learn drills and exercises that can be of each other. Therefore, within the context of a demanding, intensified setting we feel the individual beneficial to quarterbacks’s performance. 9 Sleep Over $275 9 Day Camp $225 Quarterback/Receiver has the best opportunity to advance and have the vitals skills necessary for success. Quarterbacks will learn how to correct the common errors Name _____________________________________ that young quarterbacks make with respect to throwing, ___________________________________________ hand-off, drops, scrambling, leadership and more. Date of Birth ___________ ______________________________________________ TYPICAL DAY Grade (next fall) _________ Age (as of 6/25/08) __________ ____________________________________________ What Will A Receiver Learn From This Camp? High School________________________________ ______________________________________________ DAY 1 Address ___________________________________ City ______________________________________ Receivers will learn the fundamentals and proper 8:30 - 9:30AM Registration, both Overnight & Day techniques of stance and start that are vital to master an Campers State __________________ Zip _______________ explosive “get off” from the line of scrimmage. 9:45 - 10:45AM Classroom Session Home Telephone ____________________________ 11:00 - 12:45PM Field Session #1 Receivers will learn basic and advanced separation 1:00 - 2:00PM Lunch Work/Emergency Phone ______________________ techniques and maneuvers to attack soft man, press 2:00 - 4:00PM Field Session # 2 E-mail Address______________________________ coverage and zone defenses. 4:30 - 5:30PM Dinner 6:00 - 8:00PM Field Session # 3 - Home Parent’s Name ______________________________ Receivers will learn fundamental “catch” drills and a Height _______________ Weight ______________ method for developing concentration and focus. These DAY 2 drills can be incorporated into a year-round skill Medical/Health Coverage:_____________________ development program. 8:00- 9:00AM Breakfast for Overnight Campers I hereby make application for my son 9:00 - 10:00AM Classroom Session _________________________________________ Receivers will learn to run basic “quick” game routes 10:15 - 12:15PM Field Session # 4 to attend the Perry 11 Football Camp at Hofstra and proper “deep ball” route techniques. 12:15 - 1:30PM Lunch University. I pledge for his compliance with all camp 2:00 - 5:00PM Field Session # 5 rules and acknowledge the risks related to my child’s Discount for High School Teams of 15 or more campers. participation in Summer Camp. Overnight - $225.00 Day Campers - $195.00 _____________________________________________ ______________________________________ (Signature of Parent or Guardian) .