Missouri Western State University
JUNE 3-7, 2013
SPORTS
ACADEMY APPLICATION
(Print the following application and
authorization form
and mail to the address below)
| DATE: |
JUNE 3-7, 2013 |
| TIME: |
1:30 PM-5:15 PM
Each Day |
| LOCATION: |
MISSOURI WESTERN
STATE UNIVERSITY GYMNASIUM AND ATHLETIC FIELD. |
| COST: |
$80.00 FOR FIRST
CHILD IN FAMILY.
$70.00 FOR EACH ADDITIONAL CHILD. (Children 8-12 years only) |
| EQUIPMENT: |
ALL EQUIPMENT FURNISHED
BY MISSOURI WESTERN STATE UNIVERSITY, DEPARTMENT OF HEALTH PHYSICAL
EDUCATION & RECREATION. |
| PARENTS DAY: |
ON FRIDAY JUNE
7TH ALL PARENTS ARE ENCOURAGED TO PARTICIPATE WITH THEIR CHILDREN. |
| DIRECTOR: |
MR. BRITT JOHNSON |
ALL STUDENTS MUST FURNISH THEIR
OWN TENNIS SHOES, SWIMMING SUITS, TOWELS AND CHANGE FOR SNO CONES. THE
HPER AND ATHLETIC DEPARTMENTS DOES NOT SUPPLY CHANGE.
|
| NAME:_________________________________ |
Male or Female AGE:(As of June 2013)_________ |
| NAME:_________________________________ |
Male or Female AGE:(As of June 2013)_________ |
| NAME:_________________________________ |
Male or Female AGE:(As of June 2013)_________ |
Children will be grouped according to their age.
| CIRCLE SHIRT SIZE(Child's
Name):______________ Youth M L
Adult S M L |
| CIRCLE SHIRT SIZE(Child's
Name):______________ Youth M L
Adult S M L |
| CIRCLE SHIRT SIZE(Child's
Name):______________ Youth M L
Adult S M L |
Do you anticipate your child being absent due to other commitments?
___Yes ___No
If yes, please provide the day(s)._________________________
| Parent/Guardian:____________________________________ |
| |
|
|
| Home Phone:_______________________ |
Work Phone:____________________ |
| |
|
|
| Address:__________________________ |
City:___________________ |
| |
|
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| State:__________________ |
Zip:____________ |
Enclosed is a check or money order in the
amount of $______ to cover the cost of the 2013 Academy.
|
MAKE CHECKS
PAYABLE TO: Children's Lifetime Sport Academy |
MAIL APPLICATION and AUTHORIZATION
TO: HPER Dept., Looney Complex 214, Missouri Western
State University, 4525 Down Drive, St. Joseph, MO 64507.
To guarantee a shirt, applications
must be received by May 24, 2013.
|
IMPORTANT: If any day your child is
sick or cannot attend Sports Academy please call Leanne Weber at 271-4491
so we will not think they are actually in attendance. Please do not
rely on a friend of your child's to tell us.
Be sure to print out the
AUTHORIZATION form from our website and send with your application.
MISSOURI WESTERN STATE UNIVERSITY IS AN
EQUAL EMPLOYMENT AND EDUCATIONAL OPPORTUNITY INSTITUTION |