2017 West Youth Volleyball League Registration Form

Participant’s Name: ______Age___ Grade (fall) ____D.O.B.______

Address: ______City______State_____Zip______

Home Phone: ______Cell ______Work______

Email: ______Pleasecircleone, I prefer to be contacted bytext or email

Parent/Guardian: ______

Physician’s Name: ______Phone #:______

Any Medical Conditions: ______

Emergency Contact Information:

Name: ______Relationship: ______

Home Phone: ______Cell: ______

Please Circle One Size Per Uniform Pieces:

Fitted Jersey Size: YS, YM, YL, AS, AM, AL

Spandex Size: YS, YM, YL, AS, AM, AL

**WYVL is not responsible for wrong sizes, parent will have to re-order if the size selected is not correct

Does child attend West ISD? ______If “no”, where: ______

Number of years played for WYVL: ______Last coach: ______

Other siblings involved in WYVL:

Name: ______Name: ______

I certify that all information on this form is true and correct and I give my consent for my child’s participation in any programs associated with WYVL. By signing this form I give my permission for the Head Coach to consent to medical attention in my absence if required. I hereby waive any claims against participants, volunteers and coaches, which may arise from any activities of the WYVL. Accident Insurance is NOT provided by WYVL. Any injury that may occur during practices, games or any other activity associated with WYVL is not the responsibility of the WYVL. Participants play at their own risk and the risk of the parent/guardian. By signing below I release the WYVL, including all volunteers and coaches, from any claims or liability.

Parent/Guardian Signature: ______Date: ______

I would like to be considered to coach a youth volleyball league team: YES or NO (please circle)

Volleyball Fee $65 *A $25.00 fee will be charged on all returned checks*

Please mail this form and payment to:

Sandy Dickerson

PO. BOX 185

Ross Tx 76684

Due July 29th

Draft July 31st 6:30 west hs. Athletic film room

*** WYVL Use Only: PD $______cash/check Rec’d by: ______

Please keep the information below the line for your information

WYVL Information:

*There will be 2 age groups, 10U (must be entering 4th grade to participate in the league) and 12U (11 and 12 year olds, any 12 year old that is 12 on or before Jan. 1 may participate), the number of teams formed in each age group will be determined based upon the number of participants

*Practices may begin on August 1st, no more than 2 per week, practices will be in West

*Games will be on Saturdays in various league towns, games will begin the middle of August, transportation must be provided by the parent

*Please mail top part of this form with payment to the above address