Camp Registration Form
To Register: Print & Mail form to MidAmerica Sports Center Attn: Summer Camps.  Prepay or Pay at Door.

Participant’s Name: _____________________________________________
Age: _____________
Grade: ___________
School: __________________________________________________
Phone Number: __________________________________________
Email: ___________________________________________________

I will not hold MidAmerica Sports Center liable for injuries while participating.
Parent/Guardian Signature

Please Circle:
General Skills                    Quads                                     Serving
Attacking                            Passing                                  Setting 

Cost:  Camps # 1, 2: $75.  Camps #3-6: $40
MSC use only:
Cash  Check   Charge
Date:                Ck#: