2017 SDSU CAMP STAFF ACADEMICS HEAD COACH TOP 80 PUBLIC UNIVERSITY Rocky Long 3 TIME MWC COACH OF THE YEAR ALL TIME WINNINGEST COACH IN MWC HISTORY ASSISTANT COACHES Jeff Horton Bobby Hauck Associate Head Coach Offensive Coordinator Running backs Associate Head Coach Special Teams Coordinator Jashon Sykes Tony White Assistant Athletic Director Football Operations Recruiting Coordinator Cornerbacks Kevin McGarry Adam Hall Director Player Personnel Assistant Athletic Director of Strength & Conditioning Danny Gonzales Doug Deakin Defensive Coordinator Safeties Assistant Football Operations Zach Arnett Ernie Lawson Linebackers Defensive Line Adam Roberts Mike Schmidt GA Offense-TE Offensive Line Demetrius Sumler Hunkie Cooper GA Defense/Sp Teams Wide Receivers Zac Shapiro Blane Morgan GA Defense Quarterbacks Ed Ulufanua Quality Control Offense 2017 AZTEC FOOTBALL CAMPS TOP 10 MOST APPLIED TO UNIVERSITY TOP 10 MOST DIVERSE C OLLEGE CAMPUS TOP 50 MOST UNDERRATED COLLEGE 7 STRAIGHT BOWLS 1 OF 20 TEAMS TO APPEAR IN 7 STRAIGHT BOWLS 2010, 2012, 2014 2011 2013 2015 2016 2012, 2015, 2016 C ONFERENCE CHAMPI ONSHIPS 63 WINS SINCE 2010 TOP 20 WINNING % IN THE COUNTRY CAMP REGULATI ONS MEDICAL FORM • Registration by mailing back brochures or online registration at Goaztecs.com Name___________________________________________________ PLEASE PRINT LEGIBLY Date of Birth_____________________________________________ Name___________________________________________________ • All Positions evaluated at camp Date of Camp____________________________________________ Address_________________________________________________ 1. List any medical conditions that camp personnel should be aware of (use additional pages if necessary): City_____________________________________________________ Due to NCAA rules, camps are open to any and all campers between the ages of those entering ninth grade and graduating seniors. Campers will be matched with and against other campers of the same age, size, and ability level. CAMPERS MUST HAVE THEIR OWN MEDICAL INSURANCE TO ATTEND. Juco athletes are able to participate. You do not have to submit a physical. CAMP INFORMATI ON QB, RB, WR, TE ,LB, DB, SPEC: Workout Gear, Cleats and Tennis Shoes OL & DL: Helmet with mouthpiece, Jersey, Shoulder pads, Workout Gear, Cleats and Tennis Shoes If your high school rules forbid the use of any equipment, such as shoulder pads, please bring all that is allowed. You will still be able to participate fully in the camp. San Diego State does not rent or loan equipment for the camp. *Camp will proceed during poor weather. CAMP APPLICATI ON ________________________________________________________ ________________________________________________________ 2. List any medications currently taking: 12:00-1:15 PMRegistration 1:45-2:30 PM Stretch/Agility Circuit 2:45-3:35 PM Offensive Postition Instruction 3:50-4:30 PM Defensive Position Instruction 4:45-5:00 PMBreak (Campers pick position to finish camp) 5:05-5:35 PM 1 on 1 Competition 5:40 PM Camp Conclusion High School Name________________________________________ Grade entering 2017 JC Gr. Sr. Jr. So. Fr. Position (Offense) QB WR RB TE OL ________________________________________________________ ________________________________________________________ 3. List any allergies: Position (Def/Spec) LB DB DL K P LS Home Phone_____________________________________________ Email____________________________________________________ ________________________________________________________ ________________________________________________________ IN CASE OF EMERGENCY PLEASE CONTACT Name___________________________________________________ Daytime Phone___________________________________________ Session (Please check appropriate box): CAMP 1 Sunday, June 4th San Diego State University 5302 55th Street San Diego, CA 92115 Evening Phone____________________________________________ Name of Medical Insurance________________________________ Company Phone Number__________________________________ Insurance Policy Numbers_________________________________ DAILY SCHEDULE State/Zip________________________________________________ __________________________, as parent or legal guardian of the participant named above, do hereby authorize the director of the sport camps and his or her subordinates, to seek any medical and/or surgical treatment which is reasonably thought to be necessary for the care of my child. The program director is authorized to provide medical treatment for my child, and I shall be fully responsible for honoring such costs. I also authorize the medical facility to release all information needed to complete insurance claims. I authorize insurance payment directly to the medical facility. I hearby waive and release San Diego State University, all members of Debrock LLC, and every individual camp staff employee, from any and all liabilities stemming from activity involved before, during, and after said event. I knowingly relinquish any and all rights of judicial action against any and all members said above. I accept full financial responsibility for any medical treatment which may occur. Pre Registration - The Cost of Camp is $50. Walk up cost of camp is $75. No Refund Policy Make Checks Payable to: DEBROCK Mail signed application with registration fee to: DEBROCK 6161 El Cajon Blvd, Suite B #459 San Diego, CA 92115 QUESTI ONS Please contact Tony White, [email protected] or 619-594-6816 For Online Registration Visit Breaks will be provided to rehydrate and replenish Signature of Parent or Guardian Date GOAZTECS.C OM
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