Bridgewater College

2008 Champions Softball Camp Application
June 16-20

Please print this page, complete the application, the medical release form and choose your camp session(s). Mail the completed form along with FULL PAYMENT for camp to Donnie Fulk, Champions Softball Camp, Box 108, Bridgewater College, Bridgewater, VA 22812. When we receive your application and deposit, we will send a confirmation letter. Make checks payable to Champions Softball Camp. Early bird special of $70 if paid by May 1st, otherwise the cost is $80.

Name____________________________________       Phone(___)____________        

Email_______________________________________        Age ____________

Address__________________________________________   

City_______________     State_______________             Zip_____________

Date of Birth____________________________________________

School you attend_______________________________________________       

Grade in Fall '08 ___________       T-Shirt Size (Adult) S  M  L  XL

              T-Shirt Size (Child)   M  L

Medical Release Form For (Players Full Name):_____________________________

NOTIFY IN CASE OF EMERGENCY

In the event my son/daughter suffers any illness or accident requiring medical treatment, medication, or hospitalization, I hereby give my permission for any medical treatment which may be deemed necessary and reasonable under the circumstances.

Signature of Parent or Guardian_____________________________________

Health Insurance Company_____________________________________

Policy Number_____________________________________

Group Number_____________________________________