Volleyball Registration PDF Print E-mail

 SSAP VOLLEYBALL 2014

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

PLATTEVIEW/SPRINGFIELD SCHOOLS AND SURROUNDING COMMUNITIES

COST $80

 

CHILDS FULL NAME___________________________________________________________

 

HOME ADDRESS:_____________________________________________________________

 

GRADE:_____________SCHOOL:__________________________________________________

 

Skills

Years involved

Need More info

Yes

NO

comments:

Played Rec

 

Clinics

 

 

 

Played Select or Club

 

Club or select

 

 

 

 

 

Private lessons

 

 

 

 

 

Coaches Clinic

 

 

Scheduled 9/16 2-4 pm

 

Shirt order form

 

Number of shirts

Sizes

Total cost

Player Shirt (Free)

 

Youth: M L     Adult: S M   L     XL

 

Club Support Shirt     ($10)

 

Youth: M L     Adult: S M   L     XL

 

 

PARENT/GUARDIAN NAMES:____________________________________________

 

PARENT/GUARDIAN EMAIL:_____________________________________________

 

PHONE: HOME_______________________CELL/WORK______________________

 

MEDICAL/PHYSICAL CONDITIONS A COACH SHOULD BE AWARE OF :

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 ($80) 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

new address TBD

REGISTRATION DEADLINE Aug 28, 2014

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

OFFICIAL ONLY:

AMOUNT PAID________________________CHECK#__________________________CASH________________________DATE_____________

Last Updated on Sunday, March 23, 2014 at 04:19 am