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Schreiner Volleyball
2015 Summer Camp
Registration Form
Please print out this form and the included
Medical Release Form. Have your
parent/guardian fill out, sign, & date these
forms to allow you to participate in our camps.
You will receive a confirmation via email.
SEND THIS FORM, THE MEDICAL RELEASE
FORM, AND MAKE CHECK PAYABLE TO:
Schreiner University Volleyball
CMB 6230
2100 Memorial Blvd.
Kerrville, TX 78028
Release of Liability for Attendees of Schreiner Volleyball Camps:
I h er eb y con s en t t o h a vin g m y ch ild p a r t icip a t e in t h e Volleyb a ll Ca m p s a t S ch r ein er Un iver s it y. I
u n d er s t a n d t h a t t h er e a r e p h ys ica l r is k s in volved in s u ch p a r t icip a t ion , a n d t h a t it is t h e r es p on s ib ilit y
of ea ch p a r t icip a n t t o en ga ge in on ly t h os e a ct ivit ies for wh ich s h e h a s t h e n eces s a r y p a r t icip a t ion a n d
s k ills . I cer t ify t h a t m y ch ild is m ed ica lly fit t o p a r t icip a t e in t h e ca m p a n d h er eb y a u t h or ize t h e ca m p
coa ch es t o a ct for m e a ccor d in g t o t h eir b es t ju d gm en t in a n em er gen cy r equ ir in g m ed ica l a t t en t ion for
m y ch ild .
I a ls o u n d er s t a n d t h a t t h e Volleyb a ll Ca m p a t S ch r ein er Un iver s it y d oes n ot ca r r y a ccid en t or h ea lt h
in s u r a n ce for ca m p p a r t icip a n t s . My ch ild p la ys a t h is / h er own r is k if s h e is n ot cover ed b y m y
a ccid en t or m ed ica l h ea lt h in s u r a n ce p la n t h r ou gh p r iva t e or gr ou p s ou r ces . Neit h er t h e Volleyb a ll
Ca m p a n d a ll it s en t it ies n or S ch r ein er Un iver s it y a r e r es p on s ib le if m y ch ild is p la yin g wit h ou t
in s u r a n ce p r ot ect ion d es cr ib ed a b ove .
Signature of Parent/Guardian: __________________________________________________________
Signer Printed Name_________________________________________phone #___________________________
Emergency Contact ______________________________________ phone # ______________________________
Email Address:__________________________________________________________
Middle School Camp: Athletes entering 5-8th grade
______Camp 1: June 9—11, 9 am—4 pm each day
$145
High School Camp: For Athletes entering 9-12th grade AND Graduated Seniors!
______June 22—24, 9 am – 4 pm each day
$145
High School Position Camps: Experienced Athletes going into 9-12th grade & Seniors!
______ LIBERO Camp: June 30, 9 am – 4:30 pm
$55
______ SETTER Camp: July 1 , 9 am – 4:30 pm
$55
______ HITTER Camp: July 2, 9 am—12 pm each day
$55
Camper’s Name: ____________________________________________________ T-Shirt Size (women’s)________
Grade Entering Fall 2015: _________Camper’s School:_______________________________________
Camper’s club team if applicable (include age division)_______________________________________
Primary Volleyball Position: _________________________
Total enclosed $____________