Team Camp Registration & Medical Release Form

All team campers, parents and/or guardians must read this form, fill in the information, sign it and give it to the registering team coach to send in. Coaches only: Send all team member forms at ONE time to the camp address.

DEPOSITS

A deposit of $57/team member or $500/team is due to reserve the teams spot for camp. Remaining camp balance payments are due before or upon check-in for camp. For the coaches clinic, you must pay in full upon registering.  CANCELATIONS &

REFUNDS

If you must cancel, please let us know immediately.  It will allow us to have the opportunity to admit another team on the waiting list.  There is a $57 non-refundable fee applied to EACH camper up until the day before camp begins. No REFUNDS will be issued for individuals or teams that cancel within a week of the scheduled start date.

Refunds will be sent within one week of camps completion.

SUPERVISION & CONDUCT

All campers are expected to conduct themselves responsibly and follow all camp rules. Teams are expected to be on-time for all sessions. No alcohol, no smoking, no drugs.  If campers are caught using or in possession of any of these, they will no longer be allowed to participate in camp. Always let your team coach know of any changes to your roster. The team chaperone attending with each team is in charge of supervision for all attending team members. Supervision will NOT be provided for by the David Rubio Volleyball camp between sessions. If you have questions or special needs, please email us. 

REGISTRATION INFORMATION

Name ___________________High School ________________Club_ _____________
Address _______________________ City ______________________State _______
Zip ________Cell (       ) ___________ Email________________________________
T-shirt size (adult sized t-shirts) S _____   M _____ L ______ XL _____ 

MEDICAL RELEASE APPROVAL

Name of Camper_________________________________ Male/Female (circle one)
Past Health ____________________Past Injuries ____________________________
Present Medication ___________________ Allergies _________________________
Insurance Company ___________ Policy ___________ Policy Holder __ ___________
Insurance Company Address _____________________________________________

I verify that my child has been checked by a licensed physician and is physically able to participate in the David Rubio Volleyball Camp.  I hereby agree and promise that I will not hold David Rubio’s Volleyball Camp nor its employees responsible for any loss, damages, or personal injury received as a result of participation.  I hereby authorize the directors of the Camp to act for my child according to their best judgement in an emergency requiring medical attention.  I agree to allow my child to be treated by a certified athletic trainer or licensed physician (if necessary) and to assume costs related to such treatment.  I authorize my insurance company to pay benefits to Student Health service or University Medical Center.  Also, I authorize the disclosure of medical information to my insurance for the purpose of claim. This camp is not an official function of the University. 

Parent or Guardian Signature ______________ Print Name __________ Date ______
Street Address __________________________________________Zip ____________ City _________________ State ______ Home (      ) _________ Cell (     ) _______________________ ________

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