Volleyball Club Registration Form

Boys Volleyball Clinic 2026

Summary

Date/Time:
Tuesdays from 5/19-7/21 6PM to 7:30PM

Location:
Bethel Bible Fellowship Church in Emmaus, PA

Age Groups: boys ages 11-15

Cost: $200

Parent / Guardian Information

This section is for parent/guardian information.  Player information will be collected on the next page.  

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Emergency Contact Information

Please provide contact information for another adult other than the parent/guardian (ex: relative, friend). In case of an emergency, we will first reach out to the Parent/Guardian(s) listed above. 

Number of Players Registering

Waiver Statement:

I have read and agree to Push The Rock's General Release agreement.

I have read the HEADS UP Concussion fact sheet for parents with my child or teen and talked about what to do if they have a concussion or other serious brain injury.

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