AZU Little Puffs Development Academy

2011 Fall Registration Form

__________________________________________________________________

 

ACADEMY SESSIONS

 

Session 1: Girls & Boys 6th grade and under training session from 12pm – 1:30pm. Cost is $90.

 

Session 2: Girls & Boys 7th & 8th graders from 1:30-3:30pm. Cost is $120. Any high school player NOT currently on a team is able to enroll.

 

 

When: September 24   &   October 1, 8, 15, 22, 29

 

Where: Paradise Valley High School. Located at: 3950 E. Bell Road, Phoenix, 85032

 

Cost for Session 1: $90

Cost for Session 2: $120

 

Registration: Pre-Registration is preferred. Pre-registration guarantees participant an AZU T-shirt.

 

Please mail bottom portion of this sheet, waiver and payment to:

18239 N. 40th St. #173, Phoenix, AZ 85032

Make checks payable to AZU Volleyball

 

Please call or text Amanda Burbridge-Liebermann with any questions. _________________________________________________________

 

Training Session you will be attending (mark one line only):

Session 1: _______

Session 2: _______

T-Shirt Size (circle one): Y / YM / YL / S / M / L / XL

 

Participant Name: _____________________________

Age: _____

Date of Birth: _________________

Grade for Fall 2011: __________________________

What school does participant currently attend: _______________________

 

Parent/Guardian Information:

 

Name:___________________________________

Email:___________________________________

 

Best number for contact: _____________________________________________________

 

 

WAIVER AND RELEASE BY PARENT OF MINOR CHILD FROM LIABILITY FOR ARIZONA UNITED VOLLEYBALL CLUB

 

I,                                              , on behalf of                                                           (hereinafter referred to as “CHILD”) HEREBY WAIVE AND RELEASE, indemnify, hold harmless and forever discharge Arizona United Volleyball Club and its agents, employees, officers, directors, affiliates, successors and assigns, of and from any and all claims, demands, debts, contracts, expenses, causes of action, lawsuits, damages and liabilities, of every kind and nature, whether known or unknown, in law or equity, that I or CHILD ever had or may have, arising from or in any way related to CHILD’S participation in any of the events or activities conducted by, on the premises of, or for the benefit of, Arizona United Volleyball Club provided that this waiver of liability does not apply to any acts of gross negligence, or intentional, willful or wanton misconduct. 

 

I understand that the activities that said CHILD will participate in are inherently dangerous and may cause serious or grievous injuries, including bodily injury, damage to personal property and/or death.  On behalf of myself, CHILD, my heirs, assigns and next of kin, I and said CHILD waive all claims for damages, injuries and death sustained to me or my property, that I or said CHILD may have against the aforementioned released party to such activity.

CHILD has the necessary and requisite skills to participate in all facets of, and activities of and requested of this facility, except as noted below. The nature of the activities has been fully disclosed and any flyer, advertisement, or brochure relating to the participating activities is expressly made a part of this WAIVER AND RELEASE.

By this Waiver, I, on behalf of said CHILD, assume any risk, and take full responsibility and waive any claims of personal injury, death or damage to personal property associated with Arizona United Volleyball Club, including but not limited to engaging in volleyball games, training at the facility, using the facility and its equipment, practicing and/or engaging in volleyball tournaments, house leagues or other related activities on and off the premises.

This WAIVER AND RELEASE contains the entire agreement between the parties, and supersedes any prior written or oral agreements between them concerning the subject matter of this WAIVER AND RELEASE.  The provisions of this WAIVER AND RELEASE       may be waived, altered, amended or repealed, in whole or in part, only upon the prior written consent of all parties.

The provision of this WAIVER AND RELEASE will continue in full force and effect even after the termination of the activities conducted by, on the premises of, or for the benefit of, Arizona United Volleyball Club whether by agreement, by operation of law, or otherwise.

I have read, understand and fully agree to the terms of this WAIVER AND RELEASE.  I understand and confirm that by signing this WAIVER AND RELEASE said CHILD and I have given up considerable future legal rights. I have signed this Agreement freely, voluntarily, under no duress or threat of duress, without inducement, promise or guarantee being communicated to me.  My signature is proof of my intention to execute a complete and unconditional WAIVER AND RELEASE of all liability to the full extent of the law. 

 

Medical Conditions.  CHILD is subject to the following allergies or medical conditions, and I authorize the facility to disclose these conditions to a physician or other medical professional in the event said CHILD should require emergency medical care: ____________________________________________________________________________

 

                                             _______________    DATE:______________________

Signature of Parent (Guardian)