WHO:
Shepherd Junior High Students
WHERE:
Shepherd Junior High
WHAT:
Shepherd Football Camp
WHEN:
$110.00 May 27 - August 7 Mon-Thurs. 6:45-9:00 AM
CONTACT:
Mike Khalil @ 472-1934
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
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$110.00 May 27 - August 7 Mon-Thurs. 6:45-9:00 AM
Account # 260-1340
Contact Mike Khalil @ 472-1934
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