ANNOUNCING OUR NEWEST CLINIC FOR OFFENSIVE LINEMEN LED BY FORMER DIVISION II ASSISTANT COACH OF THE YEAR BRIAN HUGHES CLICK HERE TO DOWNLOAD OUR PAPER REGISTRATION FORM OR REGISTER ONLINE WITH THE FOLLOWING FORM 2023 Spring O-Line Clinic Online RegistrationLine Clinic for Offensive Linemen on Tuesday Nights from 7-9pm at Field of Dreams Park (West Practice Field), 5619 Old Sunrise Hwy, Massapequa, NY 11758Please enable JavaScript in your browser to complete this form.Athlete's InformationPlease submit a separate form for each clinic participantAthlete's Name *FirstLastBirthdate *HS Grad Year *2022 (or prior)202320242025202620272028202920302031 (or later)School or Youth OrganizationAthlete's InstagramAthlete's TwitterParent/Guardian InfoParent/Guardian Name *FirstLastParent/Guardian Email *Parent/Guardian Phone *AddressAddress Line 1Address Line 2CityAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeHealth info & waiversI acknowledge that the above listed athlete is healthy and has been cleared by a physician to participate in physical activity consistent with football training. I hereby authorize Prime Time Sports Camps Inc. to act for the above listed athlete according to their best judgment in an emergency situation, and hereby waive and release Prime Time Sports Camps Inc., its staff and the facility from any and all liability for injuries while at the clinic. I understand that accident insurance is provided, but health insurance is not. Health Insurance Company: *Insurance Policy Number: *Payment & Enrollment InformationRegistration is not final until at least a deposit is received. Payments in cash/check avoid 3.5% processing fees. After registering you will receive an email with details for attending clinics and making any further payments necessary.Team/Organization Discount CodeOnly enter a code if your team or organization provided you with a discount code. Be sure to enter it correctly here to see your discounted rates on this form. Leave field blank if your team did not provide you with a code. Entering a fake or wrong code will prevent you from completing the form.Payment Options: *Pay $50 Deposit via credit card now (processing fee applies); balance to be paid by cash/check prior to or at your first attended sessionPay in full now via credit card (processing fee applies)mail in deposit or full payment via checkChoose the number of sessions in which you would like to enroll: *1 session ($60)2 session ($120)3 sessions ($180)4 sessions ($225)5 sessions ($280)6 sessions ($335)7 sessions ($390)8 sessions ($430)9 sessions ($485)10 sessions ($535)11 sessions ($550)Choose the number of sessions in which you would like to enroll: (Discount Pricing listed) *1 session ($50)2 session ($100)3 sessions ($150)4 sessions ($180)5 sessions ($225)6 sessions ($270)7 sessions ($315)8 sessions ($345)9 sessions ($390)10 sessions ($430)11 sessions ($450)Choose the number of sessions in which you would like to enroll: *1 session - $ 62.102 sessions - $ 124.203 sessions - $ 186.304 sessions - $ 232.905 sessions - $ 289.906 sessions - $ 346.757 sessions - $ 403.658 sessions - $ 445.059 sessions - $ 502.0010 sessions - $ 553.7511 sessions - $ 570.40processing fee of 3.5% included in priceChoose the number of sessions in which you would like to enroll: (Stallions Pricing Listed) *1 session - $ 51.802 sessions - $ 103.503 sessions - $ 155.254 sessions - $ 186.305 sessions - $ 232.906 sessions - $ 279.457 sessions - $ 326.058 sessions - $ 357.109 sessions - $ 403.6510 sessions - $ 445.0511 sessions - $ 466.78processing fee of 3.5% included in priceClick each of the sessions you plan to attend (changes can be made by notifying us in advance). Must select at least the first session you plan to attend:: *March 14March 21March 28April 4April 11April 18April 25May 2May 9May 16May 23All sessions are Tuesday nights from 7-9pm at Field of Dreams Park (5619 Old Sunrise Hwy, Massapequa, NY 11758) on the west practice field DepositPrice: $ 51.80$50 deposit plus $1.80 processing feeTotal$ 0.00Stripe Credit Card *CardName on CardSignature *Clear SignatureI agree to health waiver stated above. I also hereby grant permission to Prime Time Sports Camps Inc., its employees and agents, to take and use visual/audio images & video of the above listed athlete. Images and videos are any type of recordings including but not limited to photographs, digital images, drawings, renderings, voices, sounds, video recordings, audio clips or accompanying written descriptions. Prime Time will not materially alter the original images. I agree that Prime time owns the images and all rights related to them. The images may be used in any manner or media without notifying me, such as websites, publications, promotions, broadcasts, advertisements, posters, and social media posts. I waive any right to inspect or approve the finished images or any printed or electronic material that may be used with them, or to be compensated for them.Captcha * = Submit Share this:TwitterFacebookLike this:Like Loading...