EOI SERVA Junior Tournament

SERVA Volleyball Tournaments

TIMES: Registration 9:00am

Tournament times 9:30am - 4:00pm

DAYS: U/12 Tuesday 6th July Boys (Spikezone and Beginners)

U/12 Wednesday 7th July Girls (Spikezone and Beginners)

U/14 Thursday 8th July

U/16 Friday 9th July

WHERE:

U/12 Spikezone/Beginners

U/14 and U/16

Chandler Park Primary School

Gymnasium Entry

Merrick St

Keysborough

Westall Secondary College

Gymnasium Entry

88 Rosebank Ave

Clayton South

(Enter Gate 3)

Athlete Information

Player Name*

First NameLast Name

Guardian / Parents Names*

First NameLast Name

Mobile*

+61Mobile Number

Address*

Street Address

Street Address Line 2

City

Postal / Zip Code

E-mail*

Volleyball skill level*

	1	2	3	4	5

1 is Begginer, 5 is Advanced

What would you prefer?*

U/12 Spikezone/beginner Boys Tues 6th July Chandler Park P.SU/14 Thurs 8th July Westall Secondary CollegeU/12 Spikezone/beginner Girls Weds 7th July Chandler Park P.SU/16 Fri 9th July Westall Secondary College

I would like to play on the same team with following players. League organizers will form teams base on this buddy list and your skill level.

I would be happy to be placed in a team by the organisers.

Yes

Emergency Contact & Health Insurance Information

Important Notes ·

Due to covid we ask that participants checkin with QR code scans prior to entering the gym. There will be entry at front of gym and exit through the back of gym.

Unfortunately spectators will not be allowed in the gym and we ask you to be socially distancing when outside the gym.

Dress appropriately. Ensure you have adequate food supplies. Keep the gym clean. The tournament organizers reserve the right to form the teams to ensure the talents of all teams are balanced. Fee: $15 per participant. Payment can be made on line at serva.online (our website preferably through bank transfer)

Emergency Contact's Name*

First NameLast Name

Relationship*

Phone Number*

Area CodePhone Number

Do you have health insurance ?

YesNo

Insurance Provider

Medicare Number:*

Does you have any allergies, chronic illness, or medical conditions that would limit high level activtiy?*

YesNo

If yes please describe*

Parental Permission For Emergency Treatment In the event of illness or accident, I give my permission for emergency treatment by qualified medical personnel for my child, and I authorize the person in charge to take my child to:

I give consent for the facility to secure any and all necessary emergency medical care for my child.*

Release of Liability.

SERVA Pty Ltd requests the right to waive liabilty of any injury the participant may incur during any volleyball activity. We ask that all participants be registered members of Volleyball Victoria Incorporated which will provide any insurance needed.

If you are not registered with Volleyball Victoria Incorporated and participate in the tournament then, you do so at your own risk.

Do you have Volleyball Victoria Inc. Registration*

YesNo

If yes to VVI registration please enter membership No: in the box.

Do you give permission for photos to be taken of your child? (Photos will only be used for our website and social media posts)*

YesNo

I have read and agree to the above conditions*

YesNo

Signature*

After completing this form, please click Submit Form. You will receive a confirmation email. If you do not receive the email within a few minutes, please check your spam; otherwise, please contact us at serva.vballinfo@gmail.com

NOTE: Places are limited.

Teams will be notified of acceptance and payment is required within 3 days .

Team entries after cut off date will be placed on a waiting list.

(COVID restrictions may determine number of teams allowed to play)