CHIEF Volleyball Registration 2022-23

CHIEF Volleyball Registration 2022-23
Player Name *

First Name Last Name
Birthdate *

Month Day Year
Date
Height
Age September 1, 2022 *
You must be a member of CHIEF to participate. Are you currently a member of CHIEF? *

Yes
Parent's Name *

First Name Last Name
Phone Number *
Please enter a valid phone number.
Email *
example@example.com
Additional Parent's Name

First Name Last Name
Phone Number
Please enter a valid phone number.
Email
example@example.com
Home Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Player email
example@example.com
What is the athlete's VB skill level?

1

2

3

4

5

1 is Beginner, 5 is Advanced
Athlete's shirt size *

Youth M Youth L Youth XL Adult S Adult M Adult L Adult XL
Areas where I/we, the parent(s), would like to volunteer. Every family is expected to pitch in and help to make the season happen. These roles are in addition to regular help with line judging, score keeping, etc.

Help manage uniform check out/in Design/Print programs for home games Coordinate team spirit apparel orders Oversee fundraising and collect player sponsorships DJ music playlists at home games Plan end-of-season awards night Manage on-line sign-ups for game volunteers Serve as tournament assistant for 2 home tournaments Oversee the concession stand Plan senior night
Emergency Contact and Health Insurance Information
Emergency Contact's Name (in addition to parent) *

First Name Last Name
Relationship
Phone Number *
Please enter a valid phone number.
Do you have health insurance in the case of a medical emergency?

Yes No. I'll pay cash
Primary Doctor *

First Name Last Name
Doctor's Phone Number *
Please enter a valid phone number.
Does this athlete have any food or drug allergies? *

Yes No
Does this athlete have any chronic illness or medical condition that would limit her activity? *

Yes No
If you answered "yes" to either of the 2 questions above, please explain further.
Please read the following Parent Guidelines and Policies. Scroll to read to the end.
I have read the above policies and agree to uphold them. *

Clear
Release of Liability:

I/we the parent(s)/legal guardian(s) of the above named child do hereby delegate to the Leadership of CHIEF Volleyball a "Power of Attorney" for the above named child for the purpose of having custody of our child and my/our consent to any needed emergency/medical treatment of said child.

In the event that I cannot be reached in an emergency, I hearby give my permission to the physician or dentist selected by the CHIEF Volleyball Leadership to hospitalize, to secure proper treatment, and/or order an injection, anesthesia, or surgery for my son or daughter as deemed necessary.

I understand that if I have medical insurance, my carrier will be billed for medical charges in the case of illness or injury while my son or daughter is on this sports related activity. I will be responsible for all medical bills not covered by insurance.

I understand that every activity sponsored by CHIEF Volleyball is carefully planned and adequately supervised by mature adults. However, even with the best of planning and precaution, unforeseen events can occur. By signing this form, as parent/guardian, I agree to assume and accept all risks and hazards inherent in this sports related special activity. I also agree not to hold CHIEF Volleyball or its volunteer leaders liable for damages, losses, or injuries to the person or property undersigned. As parent/guardian I understand that I am signing for the minor named on this form and the signature(s) are to provide the power of attorney, the medical release, and the liability release.
Signature *

Clear
Below is a copy of the Player Guidelines and Policies. This will be handed out to players and read/signed at one of the first practices.
The player fee for our 18 and under team (high school) is $185.

The player fee for our 14 and under team (junior high) is $150.

Payments are due by August 5th, 2022.

Please bring payment (checks made out to "CHIEF Volleyball") to practice and give to the head coach or AD.

After completing this form, click "Submit".

If you have any questions or problems, email the CHIEF Volleyball Athletic Director at classen.carmen@gmail.com or text at 785-341-1859.
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