Volleyball Training Registration Form

2023 Volleyball Training Registration

Monday 6-8pm
Athlete Name

First NameLast Name
Phone Number

Area CodePhone Number
Athlete Skill Set
Athlete Grade
Guardians Name

First NameLast Name
Guardians Phone Number

Area CodePhone Number
Guardian Email Address
example@example.com
Training Fee
Source of Payment
Monday 6-8pm

Mansfield Fieldhouse
Emergency Contact
Emergency Contact

First NameLast Name
Relationship
Phone Number

Area CodePhone Number
Do you have Health insurance

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

YesNo
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.
Signature

Clear
Name of Physician / Emergency Medical Care Facility
Important Notes

Please dress appropriately in shorts, biker shorts, tshirt, and knee Pads. Bring Water and a volleyball. Get ready to have some fun and learn the game of volleyball.
Signature

Clear
Comments / Questions:
Should be Empty:

2023 Volleyball Training Registration