CHIEF Boys Volleyball Registration 2024

CHIEF Boys Volleyball Registration 2024
Player Name*

First NameLast Name
Birthdate*

MonthDayYear
Date
Height
Yes
Yes
Age September 1, 2023*
Parent's Name*

First NameLast Name
Parent's Phone Number*
Please enter a valid phone number.
Parent's Email*
Additional Parent's Name

First NameLast Name
Additional Parent's Phone Number
Please enter a valid phone number.
Additional Parent's Email
Home Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Player Email
Emergency contact and health information
Emergency Contact's Name (in addition to parent)*

First NameLast Name
Relationship
Emergency Contact's Phone Number*
Please enter a valid phone number.
YesNo
YesNo
If you answered "yes" to either of the 2 questions above, please explain further.
Please read the following Program Policies and Guidelines. Scroll to read to the end.
I have read the above policies and agree to uphold them.*

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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 Boys 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.

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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 high school team is $160.

Payments are due by March 22nd, 2024.

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

After completing this form, click "Submit".

If you have any questions or problems, email the CHIEF Boys Volleyball Head Coach at micahvharp@gmail.com or text at 585-705-0015.
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CHIEF Boys Volleyball Registration 2024

Emergency contact and health information