2018 Spring Club League - Loudoun County Volleyball
This is a registration form for the Loudoun County Volleyball Spring Club League
Email address *
BEFORE YOU FILL IN AND/OR SUBMIT THIS FORM, PLEASE READ ALL INFORMATIONS.
Release and discharge agreement
By submiting this form you agree with the medical release form and forever discharge Loudoun County Volleyball club and any of its employees or representatives from any and all claims, demands, actions or cause of action, past, present or future arising out of any damage or inquiry while participating in this league.
Payment Policy
By submitting this form you agree with this Payment Policy.

Payment will be done by check (price is $425 - four hundred and twenty five dollars) on the first day of practice. Current Winter Club League athletes will have a $25 off. Please, make the check payable to LOUDOUN COUNTY VOLLEYBALL.

Refund Policy
No refund will be done after first week of practice. By submitting this form you agree with this Refund Policy.
GENERAL INFORMATION
Age group of interest *
Athlete's full name *
Your answer
Athlete's birthdate *
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DD
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YYYY
Parent's (mother or father)/Guardian's full name *
Your answer
E-mail address for contact (please list an e-mail address that we can contact for information and updates) *
Your answer
Have your child ever participated in one of the Loudoun County Volleyball club programs before? *
MEDICAL RELEASE FORM
In case of emergency contact (please provide full name, phone number, e-mail address and residency address): *
Your answer
Athlete's allergies (please list all allergies, including medical substances/medicines. Do not leave this question blank - for no allergies, write NONE): *
Your answer
Medical/Physical conditions (please list all diseases, syndroms and/or special conditions the athlete may have; Do not leave this question blank - for no medical/physical conditions, write NONE): *
Your answer
Medical Insurance Information (name your insurance company and policy/group ID number): *
Your answer
Family's Physician contact (please provide full name and phone number): *
Your answer
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