CAMP REGISTRATION

July 9th through 13th, 2014

*Dates are subject to change*


Welcome to our on-line registration form. Please complete the form below in itís entirety. When finished, click "SUBMIT FORM" to register for the 2014 BUFFALO BILLS / JIM KELLY FOOTBALL CAMP. Click "RESET FORM" at any time to reset all fields.

TUITION

To register, payment in full of the $299 or a deposit of $100 must be accompanied with this application in order to reserve a spot. Enrollment is limited, so early registration is encouraged. Those accepted will receive a written confirmation within two weeks of receiving the application.


You'll be prompted for payment information after hitting "Submit Registration" button!

 

2 FREE TICKETS TO BILLS BUCS GAME. LIMITED TIME OFFER

Jim Kelly Football Camp is offering two tickets to the Bills Kids Day preseason game on August 23rd to every child who registers. Sign your child up today to receive this limited time offer for the Bills-Buccaneers game at Ralph Wilson Stadium!

http://blogs.buffalobills.com/2014/04/24/two-free-bills-bucs-tickets-with-jim-kelly-camp-registration/

 
Camper Information

* IS REQUIRED
* CAMPER'S NAME  
* PARENT/GUARDIAN NAME  
* NAME OF PERSON PAYING ENROLLMENT FEE  
* ADDRESS  
CITY  
STATE  
* ZIP CODE  
* TELEPHONE (HOME)  
* EMERGENCY TELEPHONE #   
CELL/PAGER  
* AGE (as of 6/15/13)  
SCHOOL ATTENDED (2011-2012)  
Have You Attended a Previous Jim Kelly Football Camp?  
No Yes -- If so, what years?
* CAMP SESSION CHOICE  
* E-MAIL ADDRESS  
* SHIRT SIZE  
(SHIRTS ARE ADULT SIZES)
 
* MEDICAL INFO  
   
* DIVISION  
* POSITION REQUEST
(OFFENSE)
 
* POSITION REQUEST
(DEFENSE)
 
 
HOW DID YOU HEAR ABOUT THE CAMP?  

TEAMMATE REQUEST [Please provide name(s) of other registered camper(s)]

 
I/We the undersigned parent(s)/guardian(s) certify that Camper has been examined by a licensed physician within the school year of 2012–2013 and according to physician, is free from any illness, injury or condition which would limit participation in the activities conducted by the Jim Kelly Celebrity Football Camp, Inc. (JKFC) I/We also confirm that all the above information is complete, accurate and correct to the best of my/our knowledge. I/We also hereby authorize the staff of JKFC to act in my/our behalf and for me/us according to their best judgment in a situation requiring first aid or medical attention for Camper. If such a situation arises, I/we authorize said persons to request pertinent medical information on my/our behalf and I/we hereby release those providing such information from any liability that might result. I/We hereby recognize that, although JKFC is a non-contact instructional endeavor, participation requires strenuous physical activity, which can result in unintentional contact and exposure to injury, impairment or the aggravation of any preexisting condition (s). I/We hereby release, discharge, hold harmless and promise to indemnify Jim Kelly, JKFC and its sponsors and staff, Jim Kelly Enterprises, Inc., Buffalo Bills, Erie County, and their trustees, officers, employees and agents from any and all causes, liabilities, damages, claims or demands whatsoever on account of any injury (including death) or accident involving Camper arising out of Camper's participation in the 2012-2013 JKFC. I/We authorize JKFC to use any and all photographs, video or other images of any kind for the purpose of promoting JKFC. JKFC reserves the right, in its sole discretion, to accept or not accept any application for enrollment. The full deposit will be returned accompanying any application, which is not accepted for whatever reason. It is the intention of JKFC to exercise its discretion in this regard with a view to the health and safety of all camp participants.


* Parent/Guardian!

By checking this box, I agree to the terms
of the parental consent and release text per above

REQUIRED!

    

 

Memories that will last a lifetime.

Camp & Clinic Schedules

Pay Balance Due

Jim Kelly - One on One