Quest For Excellence Volleyball Camp

 

2007 Camp Registration Form

 

Camps

    Please select the level you are registering for:

 

Individual Skills Camp (lunch is on your own) = $200.00

    July 9-12, 2007 from 9:00 AM - 4:00 PM (we will take a break for lunch from 12-1).

 

Grimsley High School Camp = $65.00

    July 30-August 3, 2007 from 8:30 AM - 12:30 PM.

 

First Name: Last Name::
Address: Position:
City: T-shirt size:
State:                     Zip: School:
Birth Date:     Age: School Coach:
Phone: JO Team:
E-mail: JO Coach:

 

Parent/Guardian Contact Information

Mother's Name: Father's Name:
Mother's Home Phone: Father's Home Phone:
Mother's Work Phone: Father's Work Phone:
Mother's Cell Phone: Father's Cell Phone
Mother's Email: Father's Email:

 

Emergency Contact Information

In the event your child is injured and we are unable to reach you as listed above, please give us an emergency contact.

Emergency Contact Name:
Emergency Contact Home Phone:
Emergency Contact Work Phone:
Emergency Contact Cell Phone:

 

I do hereby acknowledge and understand that my child’s participation in the Quest For Excellence Volleyball Camp is purely and entirely voluntary and that the Camp shall not be in any way responsible or liable for any injuries, ailments, infirmities and/or disabilities which my child may encounter as the result of such participation.  I understand the nature of potential risks from injury, and I agree to accept those risks.  Our child named above is in good health and able to participate in organized camp activities. We have adequate medical insurance coverage.

 

Camper’s Health Insurance Company:

Camper's Health Insurance Policy #:

Parent/Guardian Name: 

 

Parent/Guardian signature: ______________________________________ Date: _____/_____/_____

 

When you have completed this form and before you hit submit, print this page, then sign and send in with your check to:

 

        Quest For Excellence Sports

        181 Forest Manor Drive

        Stokesdale, NC 27357

 

Thank you.