2004 Track Camp

The University of Akron Track & Field Camp
Events - Pole Vault, Shot, Discus, Sprints, Hurdles
Camp Date: June 17-19, 2004

Cost: Commuter $150.00 Resident $ 225.00

Must be postmarked by June 9, 2004 Late Registration is $200.00 commuter and $275.00 resident.
Refund policy: Full refund minus $10 service charge for cancellations of any reason. No refund for cancellations within 48 hours of camp or no-shows.

Camp will begin with registration at noon on June 17 and conclude at noon on June 19. Please plan pick-up and drop off accordingly.

Residents should bring bathing products and training clothes for three days. Residents will be provided all applicable meals. Commuters will receive lunch only.
Participants should bring a water bottle.
All sessions will be held in JAR Arena and/or Lee Jackson Field.
Throwers should bring throwing shoes and implements.
Vaulters should bring their poles.
Storage for poles & implements can be provided overnight.
Participants should bring specialty shoes.
Certified athletic trainer will be on staff.
Registration will be at Lee Jackson Track & Field Complex located on the corner on Exchange and Union Streets

Clinic Insurance
The University of Akron Track & Field Camp provides secondary accident/medical insurance.
Medical Information/Emergency Authorization
Each participant must have a completed medical information/emergency authorization form on file with the clinic each year. The form is on the back of the clinic registration.

For More Information Contact
Brian Forrester @ (330) 972-7796 or bcf3@uakron.edu
Return application /fee to
The university of Akron Track & Field Camp
JAR Arena, Room 178G
Akron, OH 44325-5201
www.uakron.edu/track

Pole Vault Staff
DENNIS MITCHELL - Head Track & Field Coach at The University of Akron. During his tenure, the program has made tremendous strides, boasting 14 All-American honors; a national champion and MAC team women's team title. USATF Associations - Assistant Pole Vault Development Chairman (1995-2001); Heartland region Pole Vault Coach; pole vault instructor at the Junior Elite Development Camp at the San Diego Olympic Training Center; and has instructed at the annual Pole Vault Summit in Reno. Current University of Akron athletes John Russell 2x All-American (18') and Kira Sims 2x All-American (14') have taken the Zips vault program to new heights.

JEANINE THOMAS - Currently a graduate assistant coach at The University of Akron. She is the former school and MAC record holder and a USATF Junior All-American in the pole vault.

Throwers Staff
BRIAN FORRESTER - Camp director and throwing events coach at The University of Akron. Brian uses an intensely enthusiastic and comprehensive approach to developing the throwers under his tutelage. Brian Has taken the Zips Throws program to new heights, establishing the University of Akron Throwers as the premier program in the Mid-American Conference

Sprints & Hurdles Staff
BRUCE BERRY - Sprints and hurdles coach at The University of Akron. Bruce has coached two Olympic trials finalists, 17 high school All-Americans and 17 New Jersey high school state champions. He was a nine-time All-American while competing for The University of Alabama.

LESHAUNTE' EDWARDS - Is a graduate of The University of Akron. He was a three-time All-American and Olympic trials qualifier with personal bests of 10.23 (100m) and 20.34 (200m).

Current University of Akron track and field athletes will also be assisting with instruction.

The University of Akron Track and Field shirts will be available for sale.

2004 Track & Field Camp Registration
This form must be completed prior to participation in The University of Akron Track and Field Camp and must accompany your registration fee. Please complete information below legibly.

Name________________________________________Age_____
Address_______________________________________________
City___________________________St_______Zip____________
Parent/Guardian________________________________________
Home Work
Phone (______)_____________ Phone (_____)______________

Emergency Contact______________________________________
Emergency Contact Phone (______)________________________
School________________________________________________
Grade (circle one) 7th 8th FR SO JR SR Coach
Events with pr's ________________________________________
_____________________________________________________
__________________________________________________________________________________________________________
*****************************************************
Please select the appropriate Camp:

_____Throws _____Vault _____ Sprints/Hurdles

Please make check payable to The University of Akron

Application will not be processed without completed medical information and emergency medical authorization on reverse.

**************************************************************
For Office Use Only:

Check # _______ Date Rec'd _______ Amt Rec'd $______

Medical Information
This form must be completed prior to participation in the 2nd Annual Track and Field Camp. Please complete information below legibly.

Allergic Reactions____________________________________________
Medication Presently Taking___________________________________
Check if known to have any of the following conditions:
[ ] Diabetes [ ] Hemophilia [ ] Epilepsy [ ] Heart Condition
Past illness or other information that would be useful in the event treatment is necessary_________________________________________
___________________________________________________________

Emergency Medical Authorization
I am aware of the risks, hazards and inherent dangers that may arise due to my child's participation in The University of Akron Track and Field Camp being held at JAR Arena and Lee Jackson Field on Saturday and Sunday, June 28 & 29, 2003. In consideration for being allowed to participate in said activity, I hereby voluntarily assume all risk of death, accident or personal damage to my person or property and hereby release, waive and discharge The University of Akron, its instructors, agents and employees (collectively referred to as "UNIVERSITY") from every claim, liability or demand of any kind, whether caused by the negligence of the UNIVERSITY or otherwise. This release shall be binding upon any heirs, administrators, executors and assigns of mine.

I further agree to indemnify the UNIVERSITY from any loss, liability, damage or cost they may incur due to my participation in said activity in any way whether caused by the UNIVERSITY or otherwise.

In the event of illness or injury resulting or arising directly or indirectly out of said activity, I hereby gives my consent and authorization for (1) the administration of emergency first aid care and treatment at the scene of an emergency by faculty, staff members or volunteers of UNIVERSITY or (2) the administration of any treatment deemed necessary by a licensed physician or dentist and (3) the transfer to any hospital reasonably accessible. This authorization is not intended to cover major surgery unless the medical opinions of two (2) licensed physicians or dentists, concurring in the necessity for such surgery, are obtained prior to the performance of such surgery.

I further declare and warrant that I am covered by sufficient medical and dental insurance and that such insurance will remain in effect during my child's participation in said clinic.

___________________________________ _______________
Signature of Parent or Guardian Date
.

The University of Akron Track & Field Camp
Events - Pole Vault, Shot, Discus, Sprints, Hurdles
Camp Date: June 17-19, 2004

Cost:
Commuter $150.00 Resident $ 225.00

Camp will begin with registration at noon on June 17 and conclude at noon on June 19. Please plan pick-up and drop off accordingly.

v Residents should bring bathing products and training clothes for three days. Residents will be provided all applicable meals. Commuters will receive lunch only.
v Participants should bring a water bottle.
v All sessions will be held in JAR Arena and/or Lee Jackson Field.
v Throwers should bring throwing shoes and implements.
v Vaulters should bring their poles.
v Storage for poles & implements can be provided overnight.
v Participants should bring specialty shoes.
v Certified athletic trainer will be on staff.
v Registration will be at Lee Jackson Track & Field Complex located on the corner on Exchange and Union Streets

Pole Vault Staff
DENNIS MITCHELL - Head Track & Field Coach at The University of Akron. During his tenure, the program has made tremendous strides, boasting 14 All-American honors; a national champion and MAC team women's team title. USATF Associations - Assistant Pole Vault Development Chairman (1995-2001); Heartland region Pole Vault Coach; pole vault instructor at the Junior Elite Development Camp at the San Diego Olympic Training Center; and has instructed at the annual Pole Vault Summit in Reno. Current University of Akron athletes John Russell 2x All-American (18') and Kira Sims 2x All-American (14') have taken the Zips vault program to new heights.

JEANINE THOMAS - Currently a graduate assistant coach at The University of Akron. She is the former school and MAC record holder and a USATF Junior All-American in the pole vault.

Throwers Staff
BRIAN FORRESTER - Camp director and throwing events coach at The University of Akron. Brian uses an intensely enthusiastic and comprehensive approach to developing the throwers under his tutelage. Brian Has taken the Zips Throws program to new heights, establishing the University of Akron Throwers as the premier program in the Mid-American Conference

Sprints & Hurdles Staff
BRUCE BERRY - Sprints and hurdles coach at The University of Akron. Bruce has coached two Olympic trials finalists, 17 high school All-Americans and 17 New Jersey high school state champions. He was a nine-time All-American while competing for The University of Alabama.

LESHAUNTE' EDWARDS - Is a graduate of The University of Akron. He was a three-time All-American and Olympic trials qualifier with personal bests of 10.23 (100m) and 20.34 (200m).

Current University of Akron track and field athletes will also be assisting with instruction.

The University of Akron Track and Field shirts will be available for sale.

_____Throws _____Vault _____ Sprints/Hurdles

Please make check payable to The University of Akron

Application will not be processed without completed medical information and emergency medical authorization on reverse.

**************************************************************
For Office Use Only:

Check # _______ Date Rec'd _______ Amt Rec'd $______

Medical Information
This form must be completed prior to participation in the 2nd Annual Track and Field Camp. Please complete information below legibly.

I further agree to indemnify the UNIVERSITY from any loss, liability, damage or cost they may incur due to my participation in said activity in any way whether caused by the UNIVERSITY or otherwise.

I further declare and warrant that I am covered by sufficient medical and dental insurance and that such insurance will remain in effect during my child's participation in said clinic.

___________________________________ _______________
Signature of Parent or Guardian Date
.

The University of Akron Track & Field Camp
Events - Pole Vault, Shot, Discus, Sprints, Hurdles
Camp Date: June 17-19, 2004

Cost:
Commuter $150.00 Resident $ 225.00

Camp will begin with registration at noon on June 17 and conclude at noon on June 19. Please plan pick-up and drop off accordingly.

JEANINE THOMAS - Currently a graduate assistant coach at The University of Akron. She is the former school and MAC record holder and a USATF Junior All-American in the pole vault.

LESHAUNTE' EDWARDS - Is a graduate of The University of Akron. He was a three-time All-American and Olympic trials qualifier with personal bests of 10.23 (100m) and 20.34 (200m).

Current University of Akron track and field athletes will also be assisting with instruction.

The University of Akron Track and Field shirts will be available for sale.

_____Throws _____Vault _____ Sprints/Hurdles

Please make check payable to The University of Akron

Application will not be processed without completed medical information and emergency medical authorization on reverse.

**************************************************************
For Office Use Only:

Check # _______ Date Rec'd _______ Amt Rec'd $______

Medical Information
This form must be completed prior to participation in the 2nd Annual Track and Field Camp. Please complete information below legibly.

I further agree to indemnify the UNIVERSITY from any loss, liability, damage or cost they may incur due to my participation in said activity in any way whether caused by the UNIVERSITY or otherwise.

I further declare and warrant that I am covered by sufficient medical and dental insurance and that such insurance will remain in effect during my child's participation in said clinic.

___________________________________ _______________
Signature of Parent or Guardian Date