MUSTANG GIRLS SOFTBALL CAMP REGISTRATION

Please complete this form, cut along the dotted line and return to Jack Dempsey

CAMP INFORMATION
Girls Ages 6-14

Campers full name____________________ Address____________________________ Date of Birth_________________________ Age on June 25_____Grade in Sept.________ Parent/Guardians Name__________________ Email Address of Parent/ Guardian____________________________ Parent/Guardians Phone #________________ In case of emergency contact_______________ I.C.E. Phone Number____________________ Parent/Guardian Signature____________________________ Date________________________________ I the parent/guardian of the above child, do hereby give my consent to his/her participation in all of the activities of Mustang Softball Camp. In case of any illness or injury to my child resulting from these activities, I hereby waive all claims against the organization, sponsors, coaches, directors, officers, and the city of Medford. I also release from responsibility any person(s) transporting my child to or from any activities. I understand my responsibility towards my childs medical bills if injury occurs. I further give consent for medical treatment by the closest hospital, doctor, or medical facility. Parent/Guardian Signature:____________________________ Date:_______________________________

June 25 - June 28 (Rain Date: June 29)

Camp runs from 9AMto 12PM Fee $125 for 1 week Families of 2 or more pay $100 per child Fees Include *Instruction *T-Shirt *Snacks & Drinks *Prizes *Free Swim at Tufts Pool What To Bring *Bat & Glove *Sneakers or cleats *Sliders/kneepads *Bathing Suit and Towel (Free swim at Tufts Pool, 1112 noon)

M USTANG GIRLS S OFTBALL C AMP S UMMER 2012

Ages 6 - 14 June 25 - June 28 (Rain Date: June 29) Tufts Park, Medford, MA

For more information contact Coach Jack Dempsey at JDSportsvideo@aol.com

A BOUT O UR C AMP
DIRECTOR Jack Dempsey

CAMP STAFF Medford High School softball coaches, varsity players and former college players.

Head Coach of Medford High School Varsity Softball Team Over thirty years of coaching High School and youth sports

ASSISTANT DIRECTOR Jackie Dempsey

Please make checks payable to: Jack Dempsey Amount of check(s) enclosed:
Medford High softball pitcher Raynne Staude

Graduated from Villanova University, Philadelphia, PA Captain, Villanova University Softball Team, 2008 Three time Big East All Star in softball Boston Red Sox Ball Girl

$_____ Send Registration form to: Jack Dempsey 6 Charles Street Lexington, MA 02421

OUR GOAL The Mustang Softball goal is to provide young softball players with quality instruction in areas of pitching, hitting, base running, catching and infield/outfield play. Players will be taught fundamentals, undergo video analysis of their mechanics, and have an opportunity to play in an organized competition.

Jackie Dempsey Villanova softball player and assistant director