E-LB Summer Volleyball '25

Elkton Lake- Benton Summer Volleyball Camp Registration
Athlete Information
Athlete's Name

First NameLast Name
Athlete Phone Number if applicable.
Please enter a valid phone number.Format: (000) 000-0000.
T- Shirt Size:
Grade going into in the 2025 -26 school year.
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Emergency Information
Emergency Contact's Name

First NameLast Name
Relationship
Phone Number
Format: (000) 000-0000.
Alt. Phone Number
Format: (000) 000-0000.
Does the athlete have any allergies, chronic illness, or medical conditions? If yes, please describe.
Is the athlete prescribed an inhaler? If yes, please explain any instructions.
Goals
What off-season goals does your athlete have?
Medical Release and Authorization

I hereby release and discharge the staff and Elkton Public School District and its officers, agents and employees from and against any and all liability or causes of actions arising out of or in connection with my participation in the camp. I further acknowledge that participation in any sports related camp involves the risk of injury and represent that I have adequate insurance coverage to insure that risk.
Confirmation

BY ACKNOWLEDGING AND SIGNING BELOW, I AM DELIVERING AN ELECTRONIC SIGNATURE THAT WILL HAVE THE SAME EFFECT AS AN ORIGINAL MANUAL PAPER SIGNATURE. THE ELECTRONIC SIGNATURE WILL BE EQUALLY AS BINDING AS AN ORIGINAL MANUAL PAPER SIGNATURE.
Date

MonthDayYear
Date
Type Name here for E-signature.
Should be Empty:

Elkton Lake- Benton Summer Volleyball Camp Registration

Athlete Information

Goals