Football Kicking Camp
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1 Football Kickig Camp REGISTER AND PAY ONLINE AT REGISTRATION AT 9 A.M. Camp begis at 10 a.m. JUNE 2, 2018 BRANDON CLAYTON Northwest s Special Teams have played a importat role i the success of our program over the last 21 years. This camp will provide you a opportuity to work with two of the best istructors i the Midwest. Joel Mathews will work with the kickers ad Kelly Goodbur will work with the puters. Bearcat Football Sice overall record NCAA Playoff record 7 first-roud byes 28 professioal cotracts siged 20 NCAA playoff appearaces 16 MIAA coferece champioships 10 Natioal champioship game appearaces 6 Natioal champioships (1998, 1999, 2009, 2013, 2015, 2016) brclayt@wmissouri.edu fax
2 Football Kickig Camp Meet the Bearcat Kickig Camp Istructors KICKERS moey for luch PUNTERS SCHEDULE 10 a.m.-1 p.m. Stretchig Techique Field goals No-step kick 1-step kick full-step kick Kickoffs 1-step kickoff full-step kick directioal kickoff oside kickoff Luch 1-2 p.m. available for purchase 2-4 p.m. Review techique Questios Competitios: accuracy (field goals) distace (kickoffs) ITEMS TO BRING soccer cleats 2 footballs marked with school ame kickig tee SCHEDULE 10 a.m.-1 p.m. Stretch Warm-up Chart Stace Steppig patter Drop Coffi corer Rugby Pooch puts Luch 1-2 p.m. available for purchase 2-4 p.m. Stretch Warm-up Chart Get offs Competitio Hag time distace Questios ITEMS TO BRING 2 footballs marked with school ame grass kickig shoes teis shoes moey for luch Joel Mathews Joel Mathews is the offesive coordiator ad was the kickig coach at Fort Osage High School i Idepedece, MO. Joel has coached high school football for 13 years. Joel graduated from Northwest Missouri State i He was the startig puter at Northwest Missouri State ad was a member of the team from Camp Staff The etire Northwest coachig staff will be workig this camp with the specialty coaches ad studet-athletes. Kelly Goodbur Kelly was a puter i the NFL for seve years from Durig his professioal career he played for the Kasas City Chiefs ad Washigto Redskis. He was the startig puter for the 1992 Super Bowl Champio Redskis. He played i a total of 85 games, ad averaged 40 yards per put. His collegiate career started at Iowa State Uiversity where he played four years for the Cycloes, ad fiished his college career at Emporia State Uiversity for oe year. His so, Kyle Goodbur, was a 4-year starter from 2011 to Register ad pay olie at
3 Football Kickig Camp 2018 REGISTRATION FORM Name (first, middle iitial, last) Address City State Zip ( ) ( ) Home phoe Studet s cell phoe Date of birth Age Name of high school School s address Grade ext fall ( ) Coach s ame Coach s phoe QB OL RB TE WR DL LB CB S Positio (circle oe) Height Weight T-shirt size S M L XL XXL (circle oe) I will atted the followig sessio: Kickig camp Jue 2 10 a.m. 4 p.m. Camp Fee: $60 before May 25 $70 after May 25 Luch $7 Combo Meal - Double Cheese Burger, Lays Chips, Chocolate Chip Cookie, Bottled Water ( ) Paret/Guardia Paret s work/cell phoe Address Perso to cotact i case of emergecy Relatioship Does this camper take ay medicatio? Yes No ( ) Phoe umber If yes, please explai: Register ad pay olie at or complete applicatio ad sed with full paymet to: Bursar s/cashierig Att: Diaa Heitma Northwest Missouri State Uiversity 800 Uiversity Drive Maryville, MO Make checks payable to Northwest Missouri State Uiversity. If the camper has ay limitatios or health problems we should be aware of, please explai: Paret s Statemet (MUST be siged) See attached agreemet.
4 ASSUMPTION OF RISK, RELEASE, AND WAVIER OF LIABILITY AGREEMENT I cosideratio of the services provided by Northwest Missouri State Uiversity, its board, employees, voluteers, participats, ad all other persos or etities actig i ay capacity o its behalf (collectively referred to as UNIVERSITY ) i cojuctio with the ( Evet ), I hereby agree to release, hold harmless, ad discharge UNIVERSITY, o behalf of myself, my childre, my parets, my heirs, assigs, persoal represetatives ad estate as follows: 1. I ackowledge that my participatio i the Evet etails kow ad uaticipated risks, which could result i physical or emotioal ijury, paralysis, death, or damage to myself, to property, or to third parties. I uderstad that such risks simply caot be elimiated. I further certify that I am willig to assume the risk of ay medical or physical coditio I may have I expressly agree ad promise to accept ad assume all of the risks existig i this Evet. My participatio i this Evet is purely volutary, ad I elect to participate despite the risks. I hereby give my coset for ay medical treatmet that may be required, as determied by a medical professioal at the medical facility, durig my participatio i the Evet, with the uderstadig that the cost of ay such treatmet will be solely my resposibility. 4. I hereby volutarily release, waive, ad forever discharge ay ad all claims of egligece agaist UNIVERSITY that relate i ay way to ay activity I udertake i cojuctio with the Evet, icludig trasportatio to ad from the Evet. 5. Should UNIVERSITY or ayoe actig o its behalf, be required to icur attorey s fees ad costs to eforce this Agreemet, I agree to idemify ad hold them harmless for all such fees ad costs. 6. I uderstad that UNIVERSITY does ot maitai a isurace policy that would provide coverage i the evet that I am ijured durig the Evet or cause ay ijury durig the Evet. I certify that I have adequate isurace to cover ay ijury or damage I may cause or suffer while participatig i the Evet, or else I agree to bear the costs of such ijury or damage myself. 7. I uderstad that UNIVERSITY may photograph, film, ad/or record ( Medium ) my participatio i the Evet. I authorize UNIVERSITY to use Medium ad my likeess i cojuctio with ay UNIVERSITY marketig ad/or promotioal materials, icludig, but ot limited to, social media accouts. I uderstad that I will ot be compesated i ay way for such use. I the evet that I file a lawsuit agaist UNIVERSITY, I agree to do so solely i the State of Missouri, ad I further agree that the substative law of Missouri shall apply without regard to coflict of law rules. I agree that if ay portio of this Agreemet is foud to be void or ueforceable, the remaiig portios shall remai i full force ad effect.
5 By sigig this documet, I expressly state that I have had sufficiet opportuity to read this etire Agreemet. I further certify that I have read ad uderstood it, ad I agree to be boud by its terms. I further ackowledge that this documet cotais a egligece waiver ad idemificatio provisios. Sigature of Participat: Prit Name: Date of Birth: Address: Phoe: Date: PARENT S OR GUARDIAN S WAIVER (Must be completed by all parets ad guardias for participats uder the age of 18) I cosideratio of (prit mior s ame) ( Mior ) beig permitted to participate i the Evet, I agree to be boud by the terms of this Agreemet ad further agree to waive ay ad all claims of egligece agaist UNIVERSITY which are brought by, or o behalf of Mior, ad which are i ay way coected with the Evet, icludig trasportatio to ad from the Evet. Paret or Guardia: Prit Name: Date: Paret or Guardia: Prit Name: Date:
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