JUNIOR SPIKERS VOLLEYBALL LEAGUE REGISTRATION


To register to our Junior Spikers Volleyball League program,
please use the form below to provide your information  *

* - All fields are required

PLAYER'S NAME:   *
ADDRESS:   *
CITY:   *
ZIP CODE:   *
PHONE:   *
E-MAIL:   *
CONFIRM E-MAIL:   *
PARENT(S) NAME(S):   * &  
SCHOOL: *
DATE OF BIRTH:  
 *
GRADE:   * (Enter the grade you'll be in 2013)
SELECT DAY/TIME:   *

HOW DID YOU
HEAR ABOUT US?:		   *

COMMENTS:  
Parent's Release
 

I,   parent of  ,
agree to the following liability release: Participation specifically agrees that Club West Volleyball, its officers, employees and agents shall not be held liable for any claims, demand, cause of action of any kind whatsoever, for or on account of death, personal injury, property damage or loss of any kind resulting from or relating to participants' use of facilities or participation in any sport, exercise or activity within or out of the Club premises, and participant agrees to hold Club West harmless for the same. I also give my permission to have the above child receive any emergency treatment deemed necessary.

I accept the terms:

Note: You must click the "I accept the terms" checkbox above to submit the form. If you do not
         agree to the Parent's Release terms, use the "Cancel Form" button.