Volleyball Club Registration Form

Girls Developmental Volleyball Clinics

Summary

Date/Time: Tuesdays 5/19-7/21 6PM-7:30PM
Location: Bethel Bible Fellowship Church in Emmaus, PA
Age: 9-13 (an exception can be made)
Cost: $200

Parent / Guardian Information

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

-

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.

required fields