SERVA Junior Tournament November 24

SERVA Volleyball Tournament

TIMES: Registration 8:45am

12 and under Tournament times 9:00am - 2:00pm

14/16 and under Tournament times 9:00am - 5:00pm

DAYS: Sunday 24th November

WHERE: Westall Primary School

Westall Secondary College

Athlete Information

Player Name 1*

First NameLast Name

Player Name 2

First NameLast Name

Guardian / Parents Names*

First NameLast Name

Mobile*

+61Mobile Number

Address*

Street Address

Street Address Line 2

City

Postal / Zip Code

E-mail*

Volleyball skill level*

	1	2	3	4	5

1 is Begginer, 5 is Advanced

What would you prefer?*

12 and Under Spikezone/beginner Boys Sunday 24 November - Westall PS & SC12 and Under Spikezone/beginner Girls Sunday 24 November - Westall PS & SC14 and Under Boys Sunday 24 November - Westall PS & SC14 and Under Girls Sunday 24 November - Westall PS & SC16 and Under Boys Sunday 24 November - Westall PS & SC16 and Under Girls Sunday 24 November - Westall PS & SC

I would like to play on the same team with following players. League organizers will form teams base on this buddy list and your skill level.

I would be happy to be placed in a team by the organisers.

Yes

Emergency Contact & Health Insurance Information

Emergency Contact's Name*

First NameLast Name

Relationship*

Phone Number*

Area CodePhone Number

Do you have health insurance ?

YesNo

Insurance Provider

Medicare Number:*

Does you have any allergies, chronic illness, or medical conditions that would limit high level activtiy?*

YesNo

If yes please describe*

Parental Permission For Emergency Treatment In the event of illness or accident, I give my permission for emergency treatment by qualified medical personnel for my child, and I authorize the person in charge to take my child to:

I give consent for the facility to secure any and all necessary emergency medical care for my child.*

Release of Liability.

SERVA Pty Ltd requests the right to waive liabilty of any injury the participant may incur during any volleyball activity. We ask that all participants be registered members of Volleyball Victoria Incorporated which will provide any insurance needed.

If you are not registered with Volleyball Victoria Incorporated and participate in the tournament then, you do so at your own risk.

Do you have Volleyball Victoria Inc. Registration*

YesNo

If yes to VVI registration please enter membership No: in the box.

Do you give permission for photos to be taken of your child? (Photos will only be used for our website and social media posts)*

YesNo

I have read and agree to the above conditions*

YesNo

After completing this form, please click Submit Form. You will receive a confirmation email. If you do not receive the email within a few minutes, please check your spam; otherwise, please contact us at serva.vballinfo@gmail.com

NOTE: Places are limited.

Teams will be notified of acceptance and payment is required within 3 days .

Team entries after cut off date will be placed on a waiting list.

My Products*

Team $120.00AUD

12 and Under will play on Badminton courts 4 a side with up to 3 subs 14/16 and under will play on regular volleyball courts 6 a side with up to 3 subs You can choose to enter as a team or as an individual

Quantity

Individual $20.00AUD

Quantity

Enter coupon

Total $0.00AUD

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