Clinic Signup Form

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Clinic Signup Form

Signup for 2023 preseason volleyball clinics at Queens College - Fitzgerald Gym

Player's full name *

Player's gender *

Female

Male

Parent's name *

Parent's phone number *

Parent's email address *

Player's grade in school *

Please call before filling in "other"

4th

5th

6th

7th

8th

9th

10th

11th

Other:

Player's Age *

Please call before filling in "other"

Other:

Will the player be available on all 16 sessions? *

Payments will not be prorated if player does not attend all 16 dates

Yes

Player must register for USAV membership before first session *

If the player is not already a registered USAV member as of September 1, 2023, they may register by going to GEVA.org, clicking on "memberships", clicking on '2023-24 GEVA/USAV memberships", and registering for a developmental membership. Player must bring their printed proof of membership and medical release form to first session (medical release form available at https://www.geva.org/juniorsresources).

Parental consent and waiver *

By writing my initials below, I confirm that I am the parent or legal guardian of the player named in this form. I authorize the staff of Creole Juniors Big Apple Volleyball to act according to their best judgment in any emergency requiring medical attention, including obtaining medical treatment and procedures for the player as may be appropriate. I hereby waive and release Creole Juniors Big Apple Volleyball and its staff from any and all liability for any injuries or illness incurred while attending the clinic. I have no knowledge of any physical impairment that would be affected by the above player's participation in the program. I agree to indemnify and hold harmless Creole Juniors Big Apple Volleyball and its staff against any and all claims for damage to or from persons or property which may be sustained or occur during participation in activities, whether damages, injuries, or loss are due to negligence or not.

Parent's initials *

Date signed *

YYYY

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