Athletics Whitworth IntranetAthleticsSoftball Camp Registration Softball Camp Registration Softball Camp Contact Information: Name: Grace Dwyer-Brinkman E-Mail: gdwyer@whitworth.edu Bob Castle - Head Coach Office Phone: None E-Mail: bcastle@whitworth.edu Athletics Office Phone: 509.777.4397 Please enter/select the following: Camp Dates. Camp Dates Exposure Camp - 7/13/24 - $100 Softball Camp August 31st, 2024 - $50 Please enter/select the following: Campers Full Name. Campers Full Name Please enter/select the following: Camper's Date of Birth. Camper's Date of Birth Please enter/select the following: Campers Email Address. Please enter the e-mail address in the form of me@you.com Campers Email Address Please enter/select the following: Campers Phone Number. Campers Phone Number High School Attending Please enter/select the following: High School Graduation Year. Please enter/select the following using only numbers: High School Graduation Year. High School Graduation Year Primary Position pitching catching infield outfield Secondary Position pitching catching infield outfield Bats Right hand Left hand Throws Right hand Left hand Please enter/select the following: Camper's Grade Level as of September <%= now.year %>. Camper's Grade Level as of September 2025 Please enter/select the following: Name(s) of Parent(s). Name(s) of Parent(s) Please enter/select the following: Mailing Address. Mailing Address Please enter/select the following: City. City Please enter/select the following: ZIP/Postal Code. ZIP/Postal Code Please enter/select the following: State. State AA (military) AB (Canada) AE (military) AK AL AP (military) AR AS AZ BC (Canada) CA CO CT DC DE FL FM GA GU HI IA ID IL IN KS KY LA MA MB (Canada) MD ME MH MI MN MO MS MT NB (Canada) NC ND NE NH NJ NL (Canada) NM NS (Canada) NT (Canada) NU (Canada) NV NY MP OH OK ON (Canada) OR Other PA PE (Canada) PR PW QC (Canada) RI SC SD SK (Canada) TN TX UT VI VT VA WA WI WV WY YT (Canada) Please enter/select the following: Parent Phone Number. Parent Phone Number Please enter/select the following: Parent Email. Please enter the e-mail address in the form of me@you.com Parent Email Sorry, your entry for Verify Parent Email did not match what you entered above. Please try again. Verify Parent Email Please enter/select the following: Emergency Contact's Name. Emergency Contact's Name Please enter/select the following: Emergency Contact Phone Number 1. Emergency Contact Phone Number 1 Please enter/select the following: I certify that my/my child's insurance company's name and active health insurance policy number are:. I certify that my/my child's insurance company's name and active health insurance policy number are: Please enter/select the following: Medical Insurance Company. Medical Insurance Company Please enter/select the following: Any restrictions and/or health concerns we should be aware of going into camp . Any restrictions and/or health concerns we should be aware of going into camp Agreement to I hereby give my consent to the Whitworth Softball staff to attend to any health problems or injury my daughter may incur while attending this camp. Further, I give my consent for medical treatment and permission to the attending physician to hospitalize, secure proper treatment, and order injections, anesthesia, or surgery. I will be responsible for any medical or other charges in connection with her attendance of camp. I agree that neither I, nor my child, will bring any claims of any kind against Whitworth University or its staff, operators or sponsors as a result of any injuries, expenses or damages that my child may suffer in connection with my child's participation in the camp, whether such claims are known or unknown or arise in the future. Please check the Medical Release Agreement box. By checking this box, I acknowledge that I have read the medical release statement and that I understand all of its terms. I sign this release voluntarily and with full knowledge of its significance. SUBMITTING