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      Sign up for Kirksville Softball Camps

      2013 KIRKSVILLE LADY TIGER SOFTBALL CAMPPlayers may attend one or multiple camps

      PITCHING AND CATCHINGCAMP WILL COVER PITCHING AND CATCHING FUNDAMENTALSMONDAY, JUNE 10,SPAINHOWER FIELDAGES 9-10: 2:00-3:30AGES 11-14: 4:00-6:00

      FIELDING AND HITTINGCAMP WILL COVER BASIC FIELDING AND HTTING FUNDAMENTALSTUESDAY, JUNE 11 and WEDNESDAY, JUNE 12SPAINHOWER FIELDAGES 11-14: 4:00-6:00

      MIDDLE SCHOOL CAMPCAMP FOR GIRLS INTERESED IN PLAYING SOFTBALL AT KIRKSVILLE MIDDLE SCHOOL DURING THE 2013-2014 SCHOOL YEARTUESDAY, JULY 23 and WEDNESAY, JULY 24NORTH PARK COMPLEXGrades 7-8: 4:00-6:00

      REGISTRATION: $30.00 Pitching and Catching $40.00 Middle School & Fielding and Hitting

      All Campers registered by May 23, will receive a camp T-shirt.(Camp participants should provide their own gloves and shoes) CAMP STAFF WILL BE THE KHS AND KMS COACHING STAFF AND PLAYERS/FORMER PLAYERS. REGISTRATION INFORMATIONFORMS AVAILABLE: ONLINE @ www.kirksville.k12.mo.us (School homepage under ??Summer Camps??)and in KHS office

      PLEASE MAKE CHECKS PAYABLE TO KIRKSVILLE TIGER SOFTBALLFORMS CAN BE DROPPED OFF AT KIRKSVILLE HIGH SCHOOL OR MAILED TO:

      KHS SOFTBALL1405 S. COTTAGE GROVEKIRKSVILLE, MO 63501

      IF YOU HAVE QUESTIONS PLEASE EMAIL:lwilliams@kirksville.k12.mo.us

      PLEASE COMPLETE REGISTRATION FORM ON BACK AND RETURN BY MAY 23 TO PRE-REGISTER!(IF YOU ARE REGISTERING ON-SITE, PLEASE BRING COMPLETED FORM WITH YOU.)** CAMPER INFORMATION**NAME: _________________________ GRADE FOR 2013-14: __________

      AGE: _____ BIRTHDATE: __________ POSITION(S): ______________________

      ADDRESS: _____________________ CITY: _________________ ZIP: _______

      HOME PHONE #: __________________ EMERGENCY #: _____________________

      SHIRT SIZE (circle): Youth: 10-12 14-16 Adult: S M L XL XXL(When in doubt on sizes, order a size too big as we do not order extra shirts!)

      PLEASE CIRCLE CAMP(S) ATTENDING:

      Pitching/Catching Ages 9-10 Pitching/Catching Ages 11-14 Hitting/Fielding Ages 11-14 Middle School Grades 7-8

      **Identification and Medical Treatment Authorization**The undersigned parents and/or guardians of (campers name) ____________________, the applicant, for and in further consideration of the softball camp acceptation said applicant, does hereby release and discharge Kirksville R-III Schools and it??s representatives, employees, and agents from any and all debts, claims, demands, actions, damages, caused of action, judgments, or suits of any kind which may arise or be occasioned as a result of any course of instruction or the applicants participation in the softball camp. In addition, I/we being the parents and/or guardians of the applicant authorize the Kirksville R-III and it??s agents permission to request emergency medical treatment or care as necessary to insure the well being of our dependent. Further, I claim the registrant has had a physical examination in the past year and was found fit for all physical endeavors.

      Signature of Parent or Guardian: _________________________ Date: ____________________Family Health Insurance Provider: ____________________________________________________Family Health Insurance Policy #: _____________________________________________________

      **Camper Code of Conduct Contract**As a participant in the Kirksville Tiger Softball Camp, I agree to comply with all of the rules, regulations, and directives of the coaching staff, and I will treat all of the coaching staff and other camp participants with respect, courtesy, and good will. I have read the above statement and understand that failure to comply with that statement may result in my removal from the camp without refund.

      Participants Signature: _________________________ Date: _______________________