This camp will focus on a variety of moves from neutral, top, and bottom with all athletes receiving one-to- one instruction. The camp will take place in a small group setting, lead by staff, to maximize learning. Partners will remain the same all week and pairings will be socially distanced. Tom Looby is the head wrestling coach and a special education teacher at BHS. There will be Brewster wrestlers and alumni working at the camp.
DIRECTOR: Tom Looby, BHS Wrestling Coach
DATES: June 28, 29, 30, July 1
TIME: 9:00 am to 12:00 pm
LOCATION: BHS Wrestling Room
GRADES: Boys entering 1st thru 8th
FEE: $65
(Payable to Town of Southeast)
ACTIVITIES REGISTRATION FORM
PROGRAM: _____________________________________________________ GRADE:________
NAME: ________________________________________________ MALE: ____ FEMALE: ____
ADDRESS: ___________________________________________________________________
CITY: _____________________________ ZIP CODE: __________
PHONE: (HOME) _______________ (WORK) _________________ (CELL) _________________
EMERGENCY CONTACT: ____________________________________ PHONE: ______________
FEE (non-refundable) : CREDIT CARD: ______ CHECK: _________ CASH: ____________
Beginning September 2017 all programs will be subject to a 2% processing fee for all credit card payments.
Expiration date: ______________ Security Code: ________________
E-MAIL ADDRESS: _____________________________________________________________
______________________ has my permission to participate in the Southeast Recreation program. I assume all risks and hazards incidental to such participation including transportation to and from activities. I do hereby waive, release, absolve, in- demnify and agree to hold harmless the sponsors and coaches for any claim arising out of an injury to my child. I also understand that it is my responsibility to notify the instructor of any MEDICAL/PHYSICAL condition that could limit my child’s participation
or that requires special attention.
PARENT/GUARDIAN SIGNATURE: _____________________________________ DATE: ________
Mail or drop off at: Town of Southeast Recreation Department
1 Main Street / Brewster, NY 10509 / phone: (845)279-3915 / Fax (845) 279-3137
E-Mail: recreation@southeast-ny.gov Website: www.southeast-ny.gov
FEE: $65
(Payable to Town of Southeast)