WHO:	7th - 9th graders
WHERE:	Fremont Junior High School
WHAT:	Summer Sports Camp
WHEN:	______A May 27 - July 10 9:00 - 12:00 Mon-Thurs
COST:	$150
COACHES:	Brent Weinberg @ 472-8321
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: PAY ONLINE CLICK HERE: www.mpsaz.org/pay click on sports camps.

-----------------------------cut along line and mail or pay on-line---------------------------------

______A May 27 - July 10 9:00 - 12:00 Mon-Thurs

$150 Summer Sports Camp - Account # 254-1340

Brent Weinberg @ 472-8321

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/we understand all risks and hazards incidental to
such 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:

Check #_____

Credit Card ______Visa ______Mastercard _____________________________3 digit Code______

Amt. Paid : __________

Exp. Date: __________

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