Blowing Rock Trails Camp       

                                July 14 to 19, 2018
   Another Great Camp read article:
                             Contact  for more information;    Cell 813-817-7744 
         Middle and High School Pre-Season Cross Country Camp
                              Coach Mirones Boys Cabin   Asst. Coach;  Girls Cabin Kristen Mirones-Brevard College

     Running Camp set in the cool mountains of North Carolina with endless   
    trails with altitudes starting  at 3500 ft. to 4800 ft. centered in the town of 
                                                     Blowing Rock , NC


                     **Thank You for our Sponsors; (you can have your companies name here by donating or sponsor a camper)
                                 Santosh Govindaraju-Convergent Capitol Partners LLC, Tampa, Fl.

                               For all your Track and Cross Country timing Florida uses         




Script embedded in HTML

                                                        Camp Application   
                                                                         (copy and paste into word document then print)     


1. All areas must be filled out with all info
r00per individuals, three runners from the same team.00

2. Send this form with parent consent and waiver  must be signed by parent/guardian;

      3.  Make checks/money order payable to Peter Mirones and camp application  to;                       
                                                                                                                     Peter Mirones
                                                                                                     17503 Woodthrush Place                                                                     
                                                                                                            Tampa, Fl. 33647

                                Please print legibly using ink. Confirmations will be sent by email once we receive  your payment

                                                                                    PARENTAL CONSENT and WAIVER

                                                                                                    Camp Waiver Must Be Signed

I understand that campers will be performing running exercises.  
That without parental permission, your child may not participate  in camp activities. Parents must provide a copy of proof of insurance that is current. My child may be  treated by medical staff during camp. I will be  responsible for cost and or medical expenses incurred during medical  treatment. I hereby wave release Peter Mirones, Blowing Rock Conference  Center, Blowing Rock Chamber of Commerce, US National Parks, Moses Cone Estate, and Blowing Rock Trails Camp employees and it’s activities, I also authorize  **The use of media photos for promotional use of The Blowing Rock trails Camp.

Parent /Guardian Sign:____________________________________________________________________


Camper Name   ___________________________  Last_______________________________________________________
                                          ( print first name)                                                                                                                                       (print last name)

Parent Cell Phone _______-   ____________________  other contact number ________-_________________

Mailing  Address ____________________________________________________________ _________________________________                             

City__________________________________________      State_____________  Zip __________________                                 Date of Birth_____/_____/__________

Camper Cell Phone_______-_______________   Grade  in Fall_________  School________________________              Coach ________________________________

Email Address ___________________________________________@______________________________________________________

Runners Cell # with area code: _______________________________________________________________________________________




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