Club Koa Pre-Tryout Clinics Registration
Athlete Name
*
First Name
Last Name
Clinic(s) Attending
*
July 8
July 11
July 15
July 18
July 22
July 25
Volleyball Experience
*
2024-25 Grade
*
Athlete Birthdate
*
-
Month
-
Day
Year
Date
Athlete Email Address
example@example.com
Parent(s) Email Address
*
example@example.com
Parent(s) Phone Number
*
Format: (000) 000-0000.
I herein consent to my daughter's enrollment in CLUB KOA GIRLS VOLLEYBALL CLINCS, held at West Valley Christian Church. I acknowledge that volleyball or any sporting event is a test of a person’s physical and mental limits and that her participation in any volleyball event can cause potential death, serious injury, or property damage. This also includes close contact that can cause sickness and is not limited to a pandemic such as COVID19, communicable diseases and various other natural and unnatural catastrophes. With a full understanding of the potential risks, I HEREBY ASSUME THE RISK OF PARTICIPATING in a volleyball event. I hereby take the following action for myself, me executors, administrators, heirs, next of kin, successors and assigns: a) I WAIVE, RELEASE AND DISCHARGE from any and all claims or liabilities for deaths, personal injury, sickness or disease from pandemic, communicable disease, and damages of any kind resulting from any event, EXCEPT THAT WHICH IS THE RESULT OF GROSS NEGLIGENCE AND/OR WANTON MISCONDUCT OF PERSONS OR ENTITIES LISTED BELOW, which arise out of or relates to my traveling to and from or my participation in any volleyball event. The FOLLOWING ENTITIES: Club Koa LLC, West Valley Christian Church, USA Volleyball and its Regional Volleyball Associations, Coaches,; b) I AGREE NOT TO SUE any persons or entities listed above or a facility that is being used for club volleyball purposes for any of the claims or liabilities that I have waived, released or discharged herein; and; c) I INDEMNIFY AND HOLD HARMLESS the persons or entities mentioned above or a facility that is being used for club volleyball purposes from any claims made or liabilities assessed against them as a result of my actions. I hereby authorize the staff of the CLUB KOA to act for me according to their best judgment in any emergency requiring medical attention. My signature on this waiver also states the above named camper is covered by my personal medical insurance and our only recourse, regardless of the nature and/or amount is to file a claim on that policy for the incident.
*
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