2010 CMass Summer Volleyball Clinic Registration Form

Register online for the 2010 CMass Summer Volleyball Clinic! Please feel free to contact us with any questions or problems.

Player's Last Name:

Player's First Name:

Date of Birth:

Current School:

Address:

City:

State:

ZIP:

Phone Number:

E-mail Address:

Parent's Name(s):

Parent's Work Phone Number:

Parent's Cell Phone Number:

Health Insurer:

Health Policy Number:

CMass Juniors Player:

Yes No

What Primary Position would you like to Play?

	Outside Hitter
	Middle Hitter/Blocker
	Right side Hitter/Opposite
	Setter
	Defensive Specialist/Libero
	Serving Specialist
	Do not have a preference

Shirt Size:

	Small
	Medium
	Large
	X-Large

Release and Consent form

My daughter has my permission to participate in the CMass Summer Volleyball Clinic. I approve of the coaches and Directors of the CMass Summer Volleyball Clinic realizing that they are serving to the best of their ability and in consideration of the benefits to be derived by the participant concerned, I hereby voluntarily waive any claim against the CMass Summer Volleyball Clinic, it’s Officers, Directors and/or agents for any and all causes which may arise in connection with this activity. I certify that the participant has full medical insurance with the company listed above. I also certify that the participant has had a complete medical exam in the last calendar year and is medically cleared to fully participate with no restrictions.

You understand and intend that your clicking on the "Submit Registration & Consent" button shall operate as your digital signature as parent and/ or legal guardian of the above captioned player.

Images courtesy of Tom Heim

CMass Juniors Volleyball - Junior Olympic Volleyball in Central Mass