2017 Summer Mentoring Registration

West Coast Sports Medicine Foundation-Team to Win 2017 Summer Mentoring Registration
THIS CLASS IS "FREE" FOR TEAM to WIN HIGH SCHOOL STUDENTS.

LUNCH/PIZZA will be provided, but feel free to bring your own lunch if pizza doesn't work for you.

CAMP DATES (choose from 2 weekends)

CAMP 1

Camp 1: ( 2 day camp) CAMP CLOSED

Saturday July 15, 2017 (9:00 to 5:00)

Sunday, July 16, 2017 (9:00 to 3:00)

CAMP 2

Camp 2: (2 day camp) CAMP CLOSED

Saturday, July 22, 2017 (9:00 to 5:00)

Sunday, July 23, 2017 (9:00 to 3:00)

Camp will be held at

Mira Costa High School Cafeteria

1401 Artesia Blvd

Manhattan Beach, CA 90266

YOU MUST ATTEND ALL OF THE CAMP TO RECEIVE YOUR CERTIFICATE OF COMPLETION
Student's Name*

First NameLast Name
Student's Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone Number

Area CodePhone Number
Cell Number

Area CodePhone Number
Enter High School or College you attend*
Grade Level
Sports Medicine experience
Do you participate in Sports Medicine/Athletic Training at your school?

Yes, 1st yearYes, 2nd yearYes, 3rd yearNO
If so who is your Athletic Trainer?
Student's e-mail

Confirmation Email
Class*
Emergency Contact

First NameLast Name
Emergency Contact Number

Area CodePhone Number
Enter the message as it's shown*
Should be Empty:

West Coast Sports Medicine Foundation-Team to Win 2017 Summer Mentoring Registration