Culver City Volleyball

CULVER CITY VOLLEYBALL CLUB
Player's Name

First NameLast Name
Team
Address

Address

Street Address Line 2

City/ZipState / Province

Postal / Zip Code
Cell
Email
example@example.com
1st Contact
Print Parent/Guardian Name
Address

Address (if different)

Street Address Line 2

City/ZipState / Province

Postal / Zip Code
Cell
Please enter a valid phone number.
Email
example@example.com
2nd Contact
Print Parent/Guardian Name
Address

Address (if different)

Street Address Line 2

City/ZipState / Province

Postal / Zip Code
Cell
Please enter a valid phone number.
Email
example@example.com
We have read and understand the rules stated in the Parent & Player Code of Conduct in the Participation Agreement Packet and that we may be subjecting my child to suspension in CCVC by my actions.
I, blank accept the financial responsibilities as stated in the Participation Agreement Packet. (Print Name of Parent/Financially responsible Adult)
Parent Signature

Clear
Date

MonthDayYear
Date
Player Signature

Clear
Date

MonthDayYear
Date
If paying by Venmo or Zelle, please let us know who the transaction is from if name is different than player's last name:
Should be Empty:

CULVER CITY VOLLEYBALL CLUB