Northumberland Breakers Volleyball 2019-2020 Tryouts Registration Form
Please complete and SUBMIT this form prior to try-outs. $20 tryout fee is paid at player check-in during the second week of tryouts.
Player Name: *
Your answer
Parent Email: *
Your answer
Player Email (if different from parents'):
Your answer
Date of Birth: *
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Sex: *
Telephone: *
Your answer
Parent Names: *
Your answer
Address (street address and city): *
Your answer
Parents, we need YOU! Please indicate if you could provide support by volunteering...
WAIVER, RELEASE AND INDEMNITY
I, for myself, my heirs, executors, administer, successors and assigns. HEREBY RELEASE, WAIVE AND FOREVER DISCHARGE NORTHUMBERLAND BREAKERS VOLLEYBALL CLUB, COBOURG COMMUNITY CENTER and PETERBOROUGH VICTORIA NORTHUMBERLAND AND CLARINGTON CATHOLIC DISTRICT SCHOOL BOARD, of and from all claims, demands, damages, costs, expenses, action and cause of action, whether in law or equity, in respect of death, injury, loss, damage to my person or property HOWEVER CAUSED arising or to arise by reason of my participation the said event, whether as spectator, participant, competitor or otherwise, whether prior to, during or subsequent to the event.

I ACKNOWLEDGE HAVING READ, UNDERSTOOD, AND AGREED TO THIS WAIVER, RELEASE AND INDEMNITY AS DEFINED ON THIS PAGE, and have indicated my acknowledgement thereof by my signature below.
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