2023 Revolution Spring Grove Developmental League Application
REVOLUTION 12U DEVELOPMENTAL LEAGUE INFORMATION 

Welcome to the Revolution Volleyball Club Spring Grove Developmental League application for the 2024 season. This league is a fun, cost effective way for players grades 5th - 7th to learn or enhance volleyball skills in a team based setting. Participants do not need to have any volleyball experience to play in the Developmental League. We do not hold tryouts and we do not make cuts for the league. The league will have a maximum size of 16 individuals. A practice t-shirt is included in the fees. Athletes must wear spandex/shorts, knee pads and athletic sneakers. As well, athletes should bring a water bottle to all events. This league is only for students in the Spring Grove School District.

Completion of this application and waiver*, by ONLY a PARENT or LEGAL GUARDIAN, is required for ALL athletes who wish to participate in developmental league for the 2024 season.

·       One form per athlete please.

·       We advise you to avoid using a smart phone to complete this form.

·       Accuracy and completeness of information is essential for the tryout evaluation and in creating team rosters.

·       Questions marked with an * require that ALL fields are completed, and you will not be able to proceed until they are complete.

PRACTICE DETAILS

·       Spring Grove Area Tech Center: 1472 Roth's Church Road, Spring Grove PA 17362

·       3:30 - 4:30 PM

·       January 4, 11, 18, 25 & February 1, 8, 15, 22

COST & PAYMENT

·       $100

·       Cash/Check: made out to Revolution VBC and mailed to 9234 Newburg Road, Newburg, PA 17240.  Please include athlete's name & location  (ex: Mary Smith 12U Spring Grove Dev. League). Due December 


By completing this application, you are indicating your commitment to participate in the Revolution Spring Grove Developmental League. This league has a maximum opening of 16 athletes.  

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Email *
ATHLETE INFORMATION 

Please enter ATHLETE (not parent) information:

(All fields must be completed. Do not use parent information as a substitute as there are fields for that information later. Use n/a in lieu of leaving a field blank.)

Athlete's Legal First Name *
Athlete's Legal Last Name *
Primary Street Address  *
City *
State *
Zip Code *
Athletes Mobile Phone (ex. 555-555-5555 or N/A) *
Athletes E-Mail (if they do not have one, enter N/A) *
Date of birth (ex: 11/11/22) *
What school does the athlete attend?  *
Athlete prefers to play the following position(s)
S = Setter
OH = Outside Hitter
OPP = Opposite/Right Side Hitter
MB = Middle Blocker
L/DS = Libero / Defensive Specialist 
NA = Not applicable or not sure at this time.  
 *

Please enter and describe your daughter's previous volleyball experience (if she has zero enter N/A):  

 *

Does the athlete have any allergies or physical conditions of which our staff should be aware?  

 *

What age will the athlete be next July1, 2024?  

 *

What grade is the athlete currently in?  

 *

What is the athlete's short sleeve t-shirt size 

 *

What is the athlete's long sleeve t-shirt size 

 *
PARENT/GUARDIAN INFORMATION

Primary Parent/Guardian Information (this person listed here will be the PRIMARY contact for the athlete) is listed first. Second Parent/Guardian Information is listed as second.

Primary Parent/Guardian First Name *
Primary Parent/Guardian Last Name *
Address *
City *
State *
Zip *
Mobile Phone (ex: 555-555-5555) *
Email *
Relationship to athlete *
Secondary Parent/Guardian First Name *
Secondary Parent/Guardian Last Name
Address
City
State
Zip
Zip
Mobile Phone (ex: 555-555-5555)
Email
Relationship to the athlete
FINANCIAL INFORMATION 

Please read each of the three statements below. They are intended to assure Revolution that you understand the time and financial commitment associated with participation in Revolution Volleyball Club. 

1.    We (athlete, parents / legal guardian) understand the costs and schedule demands of the Revolution 12U Developmental League for which the athlete has expressed interest.

2.    We understand that development of the athlete relies heavily on the individual's participation in scheduled commitments. As such, the athlete's commitment is one that should be kept in proper context to other activities.

3.    We understand that is ANY of the following (listed below) are the case with the athlete or family, we must make it known to the Revolution Director prior to the start of the league. These situations do not necessarily prohibit the athlete from participating. If any of these apply to the athlete's circumstance, please explain below.

·       Costs are prohibitive for the athlete's participation.

·       The athlete has regular practice conflicts 

By selecting YES, you are confirming that all have reviewed the Revolution information listed in this tryout application and understand the commitments involved.   
 *
MEDICAL & LIABILITY WAIVER 

MEDICAL & LIABILITY WAIVER

In consideration of being allowed to participate in any in way in any Revolution Volleyball Club program, related event and/or activities, I the undersigned, acknowledge, appreciate, and agree that:

1.    The risk of injury from the activities involved in this program is significant, including the potential for permanent paralysis and death.

2.    COVID-19 continues to pose health risks due to its highly contagious characteristics. I understand the contagious nature of COVID-19 and assume the risk that my child(ren) and I may b exposed to or infected by COVID-19 by attending the  Club and that such exposure or infection my result in personal injury, illness, permanent disability, and death.

3.    I knowingly and freely assume all risks, both known and unknown, even if arising from the negligence of the releases or others, and assume full responsibility for my participation.

By clicking "agree" to this waiver, I certify that I, as parent/guardian with legal responsibility for the participant, do consent and agree to her/his release as provided above of all the Releases, and, for myself, my heirs, assigns and next of kins, I release and agree to indemnify and hold harmless Revolution Volleyball Club, its officers, officials, agents and/or employees, other participants, sponsors, advertisers and if applicable, owners and lessors of premises used to conduct the event, from any and all claims, demands, losses and liability arising out of or related to any injury, disability or death I may suffer, or loss of damage to persona or property, whether arising from the negligence of the releasees or otherwise, to the fullest extent permitted by law.

I have read this release of liability and assumption of risk agreement, fully understand it's terms, understand that I have given up substantial rights by signing it, and sign it freely and voluntarily without any inducement. 

I/We agree. Enter your initials (this serves as your electronic signature)  

 *

Enter the date this form is completed:

 *
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REVOLUTION 12U DEVELOPMENTAL LEAGUE KRVA MEMBERSHIP
Revolution Information can be found at www.revolutionvolleyball.org. Any athlete signing up for the Revolution 12U Developmental League must have a current KRVA Athlete Tryout Pass ($15) which can be purchased using this link: Tryout Pass Link. Once the league starts, the athlete must upgrade their membership to to a Junior Select Membership for an additional $15 here: Junior Select Link. Revolution will collect the athlete's USAV Medical Release Form after teams have been selected. 

Please contact Revolution League Director, Jaime Ferguson with any questions or comments at jferguson@revolutionvolleyball.org. 
A copy of your responses will be emailed to the address you provided.
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