WD Nation Tryouts 24-25 - 16s 
Welcome to WD Nation 16s Baton Rouge Location Tryouts! November 20, 2024 
Location: UHigh Old Gym-45 Dalrymple Dr, Baton Rouge Time 6:00-8:00. *Arrive 15 minutes early
Tryout Fee is $50 please venmo: @diana-tullis-1 or Cashapp $DanielleScottArruda
Questions: daniellescottoly@gmail.com   
Players will receive an email with an invitation to join WD Nation Baton Rouge on or before November 20. When you accept, a non refundable payment of $400 is due no later than November 22, 2024  monthly installments venmo: @diana-tullis-1 

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Athlete's Full Name *
Birthday *
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DD
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High School Name *
Tryout date *
Required
My experience playing club *
Previous Club Name *
What position are you trying out for? *
What other positions do you have experience playing? *
Required
Parents Name  *
Parents Email Address *
Phone Number *
Venmo/Cashapp Information *
Top 3 Favorite Jersey Numbers (number not guaranteed) *
USAV Medical Release Complete *
The next few sections is the USAV Medical Release Form

Insurance info *fill in below

Primary Insurance Co _____________________________

Primary Group/Policy #________ / _________ 

Family Physician Name ___________________________

Physician Phone____________________

 *

In the space below please elaborate on any medical conditions of which we should be aware. 

Please list any allergies Please list any medications currently being taken in the answer section.

 If None, please write None.

Answer yes or no, In the past 24 months, have you been tested, diagnosed and/or treated for a concussion? 

If yes, provide the date (months and year), who performed the testing/diagnosing/treatment and what was the outcome:

 *

Participant,___________________________________,has my permission to participate,in training, competition, events, activities and travel sponsored by USA Volleyball or any of its Regional Volleyball Associations (RVAs). I approve of the leaders who will be in charge of this program. I recognize that the leaders are serving to the best of their ability. I certify that the participant has full medical insurance with the company listed above. I understand and agree that this document will be kept in the possession of authorized adult team personnel and that reasonable care will be used to keep this information confidential. I agree to allow the authorized adult team personnel to release this information in the event of a medical emergency to a third party medical provider. I also certify to the best of my knowledge that the participant named hereon is physically fit to engage in the activities described above. 

Parent/Guardian Signature:_____________________ Date:_______ 

Relationship to Participant: ______________________

*Filling in below represents Player and Parent/Guardian signature for approve for participation in tryout.  If accept invitation, this will be valid throughout 24/25 season.  Please Type Athlete's name, Parent/Guardian signature, Relationship to participant and date below.


If, during the course of my daughter's/son's activities in volleyball, she/he should become ill or sustain an injury, I hereby authorize you to obtain emergency medical/dental care.  I will assume financial responsibility for the bills incurred through my insurance company.

OR

I do not authorize emergency medical/dental care for my daughter/son.

Parent/Guardian

Signature:______________________________________

Date:___________________

*Please Answer Yes or No, Name and Date

DANIELLE SCOTT ENTERPRISES AND WD NATION ACCIDENT WAIVER AND RELEASE OF LIABILITY FORM
I hereby assume all of the risks of my child’s participating in WD Nation and Danielle Scott Enterprises, club, leagues, clinics including, for example and not limited to, any risks that may arise from negligence or carelessness on the part of the persons or entities being released, from dangerous or defective equipment or property owned, maintained or controlled by them, or because of their possible liability without fault.

I certify that my child is physically fit and is not participating against the advice of a qualified medical professional. I certify that there are no health-related reasons or conditions which preclude my child’s participation in Danielle Scott Enterprises and WD Nation programs. I acknowledge that this Accident Waiver and Release of Liability Form will be used by organizers of Danielle Scott Enterprises/ WD Nation programs which my child may participate and that it will govern my actions and responsibilities at said Danielle Scott Enterprises/WD Nation programs.

In consideration of my application and permitting my child to participate in Danielle Scott Enterprises/WD Nation programs, I hereby take action for myself, my executors, administrators, heirs, next of kin, successors, and assigns as follows:
• (A) I WAIVE, RELEASE, AND DISCHARGE from any and all liability, including but not limited

to, liability arising from the negligence or fault of the entities or persons released, for my death, disability, personal injury, property damage, property theft, or actions of any kind which may hereafter occur to me including my traveling to and from Danielle Scott Enterprises/WD Nation programs. THE FOLLOWING ENTITIES OR PERSONS: Danielle Scott Enterprises, Danielle Scott-Arruda, U High School, and/or their coaches, agents, representatives, volunteers or any affiliates.

• (B) I INDEMNIFY, HOLD HARMLESS, AND PROMISE NOT TO SUE the entities or persons mentioned in this waiver from any and all liabilities or claims made as a result of participation in Danielle Scott Enterprises/WD Nation programs, whether caused by negligence or otherwise.

I acknowledge Danielle Scott Enterprises/WD Nation programs may carry with it the potential for death, serious injury, and personal loss. The risks may include, but are not limited to, those caused by terrain, facilities, temperature, weather, condition of participants, equipment, vehicular traffic, actions of other people including, but not limited to, participants, volunteers, spectators and coaches.

I CERTIFY THAT I HAVE READ THIS DOCUMENT, AND I FULLY UNDERSTAND ITS CONTENT. I AM AWARE THAT THIS IS A RELEASE OF LIABILITY AND A CONTRACT AND I SIGN IT ON MY OWN FREE WILL.

PARENT/GUARDIAN WAIVER FOR MINORS (under 18 years old) The undersigned parent and/ or legal guardian does hereby represent that he/she is in fact, acting in such capacity, has consented to his/her child or ward’s participation in Danielle Scott Enterprises programs, and has agreed individually and on behalf of the child or ward, to the terms of the accident waiver and release of liability set forth above. The undersigned parent or legal guardian further agrees to save and hold harmless and indemnify each and all parties referred to above from all liability, loss, cost, claim, and/or damages which may be imposed upon said parties because of any defect on lack of such capacity to so act and release said parties on behalf of the minor.

Danielle Scott Enterprises/WD Nation and/or their coaches, agents, representatives or volunteers may take photographs or digital recordings of my child’s participant during events and use them in any and all media for training or promotional purposes. I waive any rights, claims or interest and I understand that there will be no financial or other remuneration.

Players Name ________________________________Date____________________ Parent/Guardian Name___________________________Date____________________

 *Filling in below represents Player and Parent/Guardian signature.  If accept invitation, this will be valid throughout 24/25.  Please Type name and date below.

 *
Before clicking submit, please take a moment to pay Tryout Fee  $50 venmo: @diana-tullis-1 or Cashapp $DanielleScottArruda *include athlete's name in memo
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By checking yes the participant, parent/guardian affirms having read and agreed to the terms and conditions for participation 
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