Emergency Medical Release & Waiver form MUST be completed  prior to 1st day of Camp

Name:

Address,
CITY & Zip:  

Grade

School

Home Phone:

() -

Parent/Guardian name
Emergency Contact
Emergency # () -
Experience, X one Beginner Intermediate Skilled
Position Played, X one  Middle OH  Setter Back Row
T shirt size/circle one           XL            L               M           S

Email address:

Experience, X one Beginner Intermediate Skilled