• EMERGENCY INFORMATION

    AND WAIVER

  • This information is required for each player and will apply to all clinics / sessions.

    Please direct inquiries to Lena Chan at lena@athenavb.net.

  • PLAYER INFORMATION

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  • PARENT / GUARDIAN INFORMATION

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  • SECONDARY EMERGENCY CONTACT INFORMATION

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  • INSURANCE AND PHYSICIAN INFORMATION

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  • MEDICAL HISTORY

  • CONCUSSION INFORMED CONSENT FORM

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  • ASSUMPTION OF RISK AND WAIVER OF LIABILITY

    RELATING TO CORONAVIRUS / COVID-19

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  • WAIVER

    RELEASE OF ALL CLAIMS AND CONSENT TO MEDICAL TREATMENT

  • In consideration of the acceptance of my entry and application to attend the Volleyball Clinic, I hereby release and hold harmless the officers, directors, staff and members of the Volleyball Clinic, from any liability, illness or property damage, that I sustain during my participation in this camp or that is in any way related to this camp. I understand that this Release applies to myself, my child (if signed by a parent or guardian), and our respective personal representatives, heirs and assigns. I represent that I or my child or ward is adequately trained to participate in this event, that I recognize the risks of injuries accompany such participation and that I acknowledge that this Release is being relied upon by all the above persons in permitting me to participate.  Each player will be solely covered by the personal insurance of the individual signing the waiver.

    If, as a result of my participation in the Volleyball Clinic, I require medical attention, I hereby give my consent to the above personnel to seek medical care for myself or my child or ward, (in the case of a parent or guardian) as is deemed necessary by authorized personnel of the camp or medical care providers. I hereby grant permission to the clinicians, its successors and assigns to use any photographs, video tapes, motion pictures,

    recordings or other record of the camp and my participation or that child or ward, for any legitimate reason.

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