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Camp:                                        

 

First Name:                              

 

Last Name:                              

 

Address:                                   

 

City:                                           

 

State:                                         

 

Zip Code:                                 

 

Home Phone:                         

 

Work Phone:                           

 

Cell Phone:                              

 

Referred By:                            

 

Goals for this camp:              

 

Years of Experience:           

 

Current Levels Worked:      

                                                    Men’s                DI DII DIII JC HS

                                                    Women’s         DI DII DIII JC HS

 

Men’s Shirt Size:                   

 

Method Of Payment:            

 

By submitting this form I agree to the use of

my likeness in video or photographic nature by               

Southern Arizona Officials Camp and its media

outlets.  I also agree to assume all of the risks

that may or can arise out of participating in camp

and to hold the Southern Arizona Officials Camp

and its staff harmless for any and all claims arising

from participation in camp. 

 

           Yes      No

 

 

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