BASKETBALL
BASEBALL
Camp #1 ............................................................. $65 Middle School Boys & Girls Grades*: 5-8 (2 days) Time: 9:30 a.m.-12:00 p.m. Date: June 13-14
Camp #6 ........................................................... $90 Baseball: Hitting & Fielding Instruction Grades*: 5-12 (4 days) Time: 9:00 a.m. - 12:00 noon Date: August 8-11
Camp #2 ............................................................. $50 Elementary Boys & Girls Grades*: 2-4 (2 days) Time: 1:00-2:30 p.m. Date: June 13-14 (At least 6 participants needed) Camp #3 ............................................................. $75 Middle School Boys & Girls Grades*: 5-8 (3 days) Time: 9:30 a.m.-12:00 p.m. Date: June 20-22 Camp #4 ............................................................. $60 High School Boys & Girls Grades*: 9-12 (3 days) Time: 1:00-3:00p.m. Date: June 27-29 Camp #5 ........................................................... $125 Boys & Girls Tutorials Grades*: 2-12 (3 students per group) Time: Five 1-hour sessions Date: By appointment
OSAA Moratorium Week: July 24-30 No contact between coaches and players.
SOCCER Camp #7 ........................................................... $35 Elementary Boys and Girls Grades*: K-4 (4 days) Time: 10:30 - 11:45 a.m. Date: August 8-11
WMS SPORTS CAMP REGISTRATION ATHLETE’S NAME: PARENT/GUARDIAN: ADDRESS: CITY:
STATE:
PHONE:
CELL:
ZIP:
EMAIL: GRADE 2016-2017 SCHOOL YEAR: T-SHIRT SIZE: (Free if registration is received 1 week prior to camp. After that, shirts can be purchased for
Camp #8 ........................................................... $75 Middle School Boys & Girls Grades*: 5-8 (4 days) Time: 4:00 - 6:00 p.m. Date: August 8-11
$10 each.) YOUTH ADULT ❑ ❑ ❑ ❑ ❑
Camp #9 ........................................................... $90 High School Boys & Girls Grades*: 9-12 (4 days) Time: 5:30 - 8:00 p.m. Date: August 8-11
Call Sheila at 503-363-2000 for information. Email: sfahndrich@westernmennoniteschool.org
* 2016-2017 SCHOOL YEAR GRADE
❑ YL
❑ XS
❑S
❑M
❑L
❑ XL
BASKETBALL CAMP #1 ...................................... $65 CAMP #2 ...................................... $50 CAMP #3 ...................................... $75 CAMP #4 ...................................... $60 CAMP #5 .................................... $125
SOCCER ❑ CAMP #7 ...................................... $35 ❑ CAMP #8 ...................................... $75 ❑ CAMP #9 ...................................... $90
Camp #10 ......................................................... $60 Youth Girls Grades*: 3-6 (4 days) Time: 9:00 - 10:30 a.m. Date: August 8-11 Camp #11 ......................................................... $90 High School Girls Grades*: 7-12 (4 days) Time: 1:00 - 4:00 p.m. Date: August 8-11
❑ YM
BASEBALL ❑ CAMP #6 ...................................... $90
VOLLEYBALL
FUNDAMENTAL SKILLS TRAINING PERSONALIZED COACHING BUILDING CHARACTER BUILDING TEAMWORK DEVELOPING A LOVE FOR THE GAME
❑ YS
VOLLEYBALL ❑ CAMP #10 .................................... $60 ❑ CAMP #11 .................................... $90
TOTAL ENCLOSED $_____ $25 DEPOSIT REQUIRED TO RESERVE SPOT 5/3
SEND TO: WESTERN MENNONITE SCHOOL SUMMER CAMPS 9045 WALLACE RD NW SALEM, OR 97304
Medical Care Consent and Release of Liability Read this agreement carefully and sign below: 1. I authorize all medical, surgical, diagnostic and hospital procedures as may be performed or prescribed by a treating physician for my child, if I cannot be reached in an emergency.
4. I understand that no one associated with the camp is authorized to alter, modify or waive any of the terms of this agreement in any way.
Summer Camp Director: Gary Hull
3. I agree that Western Mennonite School retains the rights to use photos taken of campers at the camp for advertising and publicity purposes only.
Western Mennonite School 9045 Wallace Rd NW Salem, OR 97304
2. I agree that neither I, nor my child, will bring any claims of any kind against Western Mennonite School or camp instructors as a result of any injuries, expenses or damages that I or my child may suffer in connection with my child’s participation in the camp, whether such claims are known or unknown or arise in the future.
Parent/Guardian
Signature
Date
Medical Insurance Company
Family Physician
www.WesternMennoniteSchool.org Physician’s Phone
503.363.2000