• Brandon Tate Camp Registration and Medical Form

     

    Camper Name:_____________________________________________________

    School:_________________  Position:________________ Grade:____________

    Age: _______________________________________________________________

    T-Shirt Size  Y-M_____    Y-L_____  S_____  M______  L _____ XL _____ XXL______

    Home Address:_______________________________________________________

    City:__________________ State:_____________________ Zip:________________

    Home Phone:____________________  Work Phone: _________________________

    Email:_______________________________________________________________

    Insurance Policy Holder:_________________________________________________

    Insurance Policy Number:________________________________________________

    Insurance Company:_____________________________________________________

    Note: Your Insurance will be the source of coverage if your child is injured.

    Physicians Name:_______________________________________________________

    Any known allergies, illnesses or injuries:____________________________________

    Date of last Tetanus Booster:______________________________________________

    This will certify that I am legal guardian for __________________________________

    And that he/she has had an adequate medical examination within a one year period and is physically able to participate in the activities of the Brandon Tate Football Camp.

    Applying for acceptance, I waive and release all rights and claims for any and all damages against the football camp or Cummings High School and it’s representatives. I hereby release and exonerate the camp and its employees from any injuries incurred in camp in camp or on the way to and from camp. In addition, I hereby state that the Brandon Tate Football Camp and Cummings High School is not responsible for any pre-existing illness or injury of the above Campers prior to the first day of camp. I give my written permission for my child to be treated by a medical doctor if deemed necessary by trainers or coaches responsible for camp operations.

    Parent or Guardian Signature:_________________________________________________________

    Emergency number:__________________________________________________________________

    Date:______________________________________________________________________________

     

     

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Cummings Cavaliers Football
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Cavaliers Conference Championships

 Mid-State 3-A Champions
1986, 1987, 1989, 1990, 1991, 1992, 1993, *1995

 Central Tar Heel 1-A Champions
 1997,1998, 2000

North State 2-A Champions
2001, 2003, 2004

 Mid-State 2-A Champions
*2005, 2006, 2010, 2011

(*Shared championship)




NC State 3-A Champions  
1988, 1990, 1992

NC State 2-A Champions  
2002, 2006

NC State 3-A Runners-up
1989, 1993

NC State 2-A Runners-up
2001, 2003