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Play Hard…,Play Fair…

Have Fun!!!

Volleyball

July 24-27, 2017

GO MUSTANGS!!!

YOU MAY STAPLE PAYMENT INSIDE & MAIL

TO MILL SPRINGS ACADEMY

C/O JAMES SAMPSON

Girls Volleyball July 24 - 27, 2017

9:00 - 12:30pm Coach Kaiser

———————————-

COST: $350.00

————————————————

MUST HAVE AT LEAST SIX (6) PARTICIPANTS

FOR CAMP TO TAKE PLACE.

GRADES 6-12 / $350.00 PER Student

INSTRUCTIONS: Complete application/waiver and send

to address below. Applications must be received by April 28,

2017.

Register online @ www.millsprings.org/sportscamps

Or Mail / Attn. MSA Sports Camps

13660 New Providence Road

Alpharetta, Ga. 30004

Student's Name: _____________________________________________

Mailing Address: _____________________________________________

City & State: ________________________________________________

E-mail Address (mother’s): _____________________________________

Work: ________________________ Cell: _________________________

E-mail Address (father’s): ______________________________________

Work: ________________________ Cell: _________________________

Parent’s Name: ______________________________________________

Amount Enclosed: ____________________

Credit Card: Master Card or Visa: ____________________________________

CCV: _____________

Signature: __________________________________________________

WAVIE OF CLAIMS: I, as parent or guardian, hereby give permission for my child to participate in Mill Springs

Academy’s sports camp program. I have and do assume all risk and will forever indemni-

fy, hold harmless, and covenant not to sue Mill Springs Academy, its employees, director,

and members from any and all liability, actions, causes of action, debts, claims, demands

or other liability of every kind and nature whatsoever which may arise from or in connec-

tion with my child’s participation in any activity at Mill Springs Academy, whether caused

by ordinary negligence or otherwise. I authorize the coaches/staff to act for me according

to their best judgment in any emergency requiring medical attention. I also give permis-

sion to Mill Springs Academy or any medical personnel to treat my child in the event of an

emergency and administer PRN medication if needed. I acknowledge that I will be

responsible for any cost (through family medical insurance or otherwise) incurred due to

sickness or injury to my child. I hereby waive any claim I might have against

Mill Springs Academy and its staff. I also understand that by submitting

this form we are committing to paying the cost of the sports camp.

Signature of Parent or Guardian: _________________________________________

Date: ___________

MUST HAVE AT LEAST SIX (6) PARTICI-

PANTS FOR CAMP TO TAKE PLACE

GRADES 6-12

$350.00 PER SESSION

———————————————

MU

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