Neon Night Volleyball Registration

Neon Night Volleyball Registration

Please provide your details, select your age group, and specify your playing position. Please wear white or neon shirts, socks, headbands, etc. There will be face paint there.
Player's Full Name

First NameLast Name
Parent's Full Name

First NameLast Name
Parent's Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Parent's Email Address
example@example.com
Player's Volleyball Position
Select Age Group
Waivers and Releases
Release Statement: The undersigned parent or legal guardian of the athlete/athletes listed above hereby consents and authorizes participation in West Polk Volleyball Academy's Volleyball Camp. I understand that my athlete/athletes will be in drills that require physical exertion and acknowledge that there is a risk of personal injury to my athlete/athletes. In consideration for WPVA accepting the above names athletes into the Volleyball Camp, I do hereby for myself, my spouse, and my athletes forever discharge West Polk Volleyball Academy, its associates, directors, affiliates, and either in law or equity, arising from or as a result of my athlete/athletes participation in WPVA Camp.
Name

First NameLast Name
Signature
Photo/Video Waiver: I knowingly give consent for the release of any photographic images that may be taken during my child’s participation in WPVA'S Neon Night for the use by West Polk Volleyball Academy for its publications, promotional materials, social media, advertisement. I hereby grant permission to the rights of my child’s image, likeness and without payment or any other consideration. There is no time limit on the validity of this release nor is there any geographic limitation on where these materials may be distributed.
Name

First NameLast Name
Signature
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Neon Night Admission
Admission for one player to Neon Night Volleyball Open Gym.

$20.00

Total

$0.00
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Neon Night Volleyball Registration

Waivers and Releases

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