WHO:
5th - 9th graders interested in Football
WHERE:
Brimhall Junior High
WHAT:
Strength, Speed, Conditioning and Football Skills
WHEN:
_____ $80
5th - 6th football
June 2-26
8:00-9:00 AM
_____ $80
7th - 8th football
June 2-26
9:00-10:00 AM
_____ $80
9th football
June 2-26
10:00-11:30 AM
_____ $60
7-9 football
July 14-31
8:00-10:00 AM
CONTACT:
Larry Farina @ 472-2651 / David Wrightson @ 472-2553
SIGN UP:
Complete the registration form below and mail with check, money order or credit card information to the address at the bottom of the page or TO PAY ONLINE CLICK HERE: www.mpsaz.org/pay Then click on Sports Camps

------------------------Cut and return here or pay on-line------------------------

_____ $80
5th - 6th football
June 2-26
8:00-9:00 AM
_____ $80
7th - 8th football
June 2-26
9:00-10:00 AM
_____ $80
9th football
June 2-26
10:00-11:30 AM
_____ $60
7-9 football
July 14-31
8:00-10:00 AM

Contact Larry Farina @ 472-2651 or David Wrightson @ 472-2553
Account # - 261-1304
TO PAY ONLINE CLICK HERE: www.mpsaz.org/pay
Then click on sports camps.
I give permission for my child to participate in the camp listed. I understand all risks and hazards
incidental to participation and do hereby waive, release, absolve, indemnify and hold harmless
Mesa Public Schools and the school from any claim arising out of any injury to my child.

Student
Name:
.
(H) Phone:
Parent/
Guardian:
.
(W) Phone:
Address:
City:
Zip:
Amt. Paid :

__________
Credit Card: ______Visa ______Mastercard

__________________________________
Exp. Date::

__________
3 Digit Code:

__________
Checks must be made payable to : Mesa Public Schools.
Mail to: Mesa Public Schools - Accounting CE, 63 East Main #101, Mesa, Az. 85201