SSAP VOLLEYBALL 2012

3^rd -4^th-5^th-6^th GRADE GIRLS

PLATTEVIEW/SPRINGFIELD SCHOOLS AND SURROUNDING COMMUNITIES

COST $60

CHILDS FULL NAME___________________________________________________________

HOME ADDRESS:_____________________________________________________________

GRADE:_____________SCHOOL:__________________________________________________

Shirt order form

PARENT/GUARDIAN NAMES:____________________________________________

PARENT/GUARDIAN EMAIL:_____________________________________________

PHONE: HOME_______________________CELL/WORK______________________

VOLUNTEER!

COACH NAME:__________________________________________________________________          

CONTACT INFORMATION:________________________________________________________

By state law, effective July 9, 1988, we must inform you that coaches, managers, referees, or anyone who prepares any playing court shall not be liable for the injury, death, or property damage of any participant in the volleyball program ran by SSAP and Papillion Recreation which results from the negligence of any of the above listed individuals. Your signature appearing below on this registration form is your acknowledgement that you clearly understand the above statement and realize that this is a release of liability. Make yourself a copy of this form when completed by you.

PARENT/GUARDIAN SIGNATURE:___________________________________________________DATE:____________________

(REQUIRED if participant is under 18 years of age)

Enclose check ($60) payable to S.S.A.P. with registration and return to Springfield or Westmont Elementary or Platteview Junior High school OR mail to:  

Shawn Carder

SSAP Volleyball

13418 Shepard st.

Omaha, Ne 68138

REGISTRATION DEADLINE Aug 28, 2011

Shawn Carder- SSAP – This e-mail address is being protected from spambots. You need JavaScript enabled to view it "> This e-mail address is being protected from spambots. You need JavaScript enabled to view it – 402-894-2214

OFFICIAL ONLY: