Player Information Form

Age Division
Tryout #
Name

First NameLast Name
Address

Address

Street Address Line 2

City/State/ZipState / Province

Postal / Zip Code
Cell
Email
example@example.com
Date of Birth

MonthDayYear
Date
Age
Height
School
Grade
Prior Club
Years of Experience
Desired Position(s)
Dominant Hand
Parent/Guardian 1 Name
Address

Address (if different)

Street Address Line 2

City/State/ZipState / Province

Postal / Zip Code
Cell
Email
example@example.com
Parent/Guardian 2 Name
Address (if different)
City/State/Zip
Cell
Email
example@example.com
I hereby authorize the staff of Culver City Volleyball Club to act for me according to their best judgement in any emergency requiring medical attention and hereby waive and release Culver City Volleyball Club and its staff from any liability for injuries or illness to my child while participating in any clinics, practice and or tryouts.
Parent Signature

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Date

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