WHO:
Individuals
WHERE:
Stapley Junior High School Gym
WHAT:
Shooting Instruction
WHEN:
______ $50
5 Hours of Instruction
All Ages
Monday - Thursday evenings
COST:
$50 Per Person
COACHES:
John Huckelberry @ 472-2746 and Rory Richeson
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:
Bring flyer and payment first night of camp.

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


______ $50
5 Hours of Instruction
All Ages
Monday - Thursday evenings
$50 per person - Account # 262-1303
John Huckelberry @ 472-2746 - jchuckel@mpsaz.org
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