Registration Form (Volleyball Camp)

First Name of Participant: Last Name:
Address:

City: State: ,  Zip:
Home Phone:              Cell Phone:        
Contact's Email:        

Grade Entering 2011-12: Choose Grade Entering 8th 7th 6th 5th   

Name & Phone of person to contact in event of emergency:

Special instructions (medical problems/needs) that instructors should be aware of:


Session I:  Grades 5 and 6 June 20-23   8:30-11:30am
Session II: Grades 7 & 8 June 20-23 1:00-4:30pm

Fee:  $55.00 (Make checks payable to A Step Ahead Camps if paying by check)
Shirt Size: YM  YL  AS  AM  AL  AXL

PARENT/GUARDIAN CONSENT FORM AND MEDICAL TREATMENT AUTHORIZATION
TO WHOM IT MAY CONCERN: In the event that the above named participant is taken to emergency room or medical care facility and in need of treatment in my absence from attendance at A Step Ahead Camp, the camp staff has my consent to authorize treatment for this participant by the doctor(s) of their choosing as the doctor(s) may deem necessary.  I, the undersigned, do hereby acknowledge that I have given the above named participant my permission to participate in A Step Ahead Volleyball Camp with full knowledge of the risks involved and I hereby agree to assume those risks and to hold the camp staff and all of their representatives free from liability for any injury, harm or complication resulting from said participation in this activity.  Furthermore I do understand that accidents insurance is not provided by the A Step Ahead Volleyball, and I hereby agree to assume full responsibility for any and all medical expenses resulting from any accidents or injuries suffered by the above named participant while participating in this activity.

Check here to indicate you have read and agree with the Parental/Guardian Consent Form. 

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