October 2009 A/E Volleyball U14 & Younger Open Gym Registration and Waiver
This series is for Girls grades 4 - 8. All participants must individually register on line with the form below.
Prior to hitting the submit button, print the form and sign it. Then mail or deliver to 6724 2nd Ave NW, Seattle, WA 98117
with check payable to A/E Volleyball. Clinics can sell out clickly. Recommend pre-payment to hold spot.
ON LINE REGISTRATION FORM STARTS HERE:
First Name *
Last Name*:
Birth Date *
School
Sex *
Grade
email:address*
Alternate
email address:
Zip
Street Address:
City:
State:
Best Phone Number to reach Parent/Guardian:(xxx) xxx-xxxx* in emergency.
Parent/Guardian
First Name *
Parent/Guardian
Last Name *
You can add additional phone #'s separated by commas
Which clinics?
You will receive confirmation stating: "Thank You. Your information has been submitted" If you forgot to print the form, use your browser button above to return to your completed form.
The back button below the message will take you back to a blank form page in case you need to resubmit or submit another person. If you do not receive the "Thank You ...." Message - you are not recorded and registered.
This clinic is provided by A/E Volleyball Association which is sanctioned and insured by AVPNext. Your payment includes an AVPNext Membership which is required to meet the requirements for the insurance for this event. Mail the above signed waiver form with check payable to A/E Volleyball. On line registration holds your spot for 48 hours. Payment by check must be postmarked within those 48 hours. You can mail or hand deliver check to mailbox at 6724 2nd NW, Seattle 98117 or hand deliver to 500 Union Street Suite 740 or pay electronically by Paypal. Bring to payment and signed form to the gym if you are within 48 Hours of the event.
If using Paypal, credit and debit cards are now accepted. Go to www.paypal.com and make payment to aevolleyball@comcast.net
You must add $3.00 to your total when paying through Paypal.
Tuesdays
USAV age group for 2010
Club 2008/9:
Full Signature *
Date:
If under 18, Parent Signature Required *
Date:
STOP! Before hitting Submit, Please Print everything above this Point (page 1 only)
Don't Forget to hit the submit button after printing
This is the end of the registration/waiver form - please print everything above this line - adjust margins to fit on one page please.Sign and deliver this form with check payable to A/E Volleyball to 6724 2nd Avenue NW, Seattle, WA 98117-4831
Note for insurance purposes everyone will be registered with AVPNext but the cost at this time is included in class fees above.
What Items do you want to work on:
Did you attend any of the other
sessions of our clinics or camps in 2009?
Were you an AVP Next Member in 2009?
ACKNOWLEDGEMENT, WAIVER AND RELEASE
By my signature below, (1) I acknowledge that I have been informed of, and fully understand, the benefits, terms and conditions of membership in AVPNEXT, for which this application is being submitted and for which the provisions of this Acknowledgement, Waiver and Release are incorporated therein, and agree to accept and abide by such terms and conditions, as they may be amended from time to time by AVPNEXT, (2) I acknowledge and understand that my involvement and participation in the volleyball event to which I am also registering, as well as any other volleyball event, is completely voluntary and not required for my membership in AVPNEXT, (3) I acknowledge and agree that there is no principal-agency relationship between AVPNEXT, its parent and subsidiaries, and each of their officers, directors, shareholders, affiliates, subsidiaries, employees, representatives, contractors, successors and assigns (individually, an “AVP Party” and collectively, “AVP Parties”), on the one hand, and the organizers, operators, promoters, sponsors, advertisers and officials of this or any other volleyball event, on the other hand, (4) I hereby release and forever discharge and waive any and all claims that I, my heirs, assigns and successors, has or may have against AVP Parties, or any of them, arising out of or in connection with my membership in AVPNEXT and/or my participation in any volleyball event, including, without limitation, any bodily injury, death or property damage, (5) I agree to let the parties use my name and likeness free of charge in any manner and for any purpose, (6) I agree to indemnify and hold harmless the AVP Parties, and any of them, from any damage, claims, costs, liabilities or expenses (including, without limitation, attorneys’ fees and expert witness expenses) arising out of or resulting from my breach of any of the terms and conditions of my membership in the AVPNEXT, including, without limitation, any breach of this Acknowledgement, Waiver and Release.
I ACKNOWLEDGE A/E VOLLEYBALL ASSOCIATION IS AN AVP SANCTIONED PARTY AND THAT THIS WAIVER AND RELEASE APPLIES TO ALL A/E VOLLEYBALL ASSOCIATION EVENTS AND TO THE ORGANIZATIONS THAT PROVIDE THE FACILITIES WHERE OUR EVENTS OCCUR INCLUDING BUT NOT LIMITED TO THE SEATTLE SCHOOL DISTRICT AND THE SEATTLE PARKS DEPARTMENT
Do you understand and accept these conditions?*:
Do you want to receive A/E Volleyball
or Cascade emails on our local events?
You must type in initials for this registration to be accepted
Do you want to receive free
AVP Next Newsletter?
Do you want to receive
free AVP Newsletter?
(if applicable)
Use separate form for
Monday & Thursday Clinics
No Refunds. Credit provided if we receive 48 hour advance written notice (email)
