HCA Volleyball Clinics 2018
Child's First Name *
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Child's Last Name *
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Date of Birth *
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What school does your child attend?
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What is your child's age? *
Parents' Names *
(First and Last Names)
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Street Address *
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City *
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Zip Code *
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Cell Phone Number *
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Email Address *
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Consent to Participate in an Athletic Event *
I (We) hereby give consent for our above mentioned child to participate in the Harvester Christian Academy Volleyball Clinics offered by Harvester Christian Academy and Preparatory School. WARNING: Participation in sports activities involves the potential for injury, which is inherent in all sports. By checking the "I Agree" box below, you release Harvester Christian Academy, its employees, directors, staff, board, and any agent of the school of any liability for any injury incurred while participating in the Harvester Christian Academy Volleyball Clinics. In the event of a medical emergency involving the above named athlete during my absence while participating in the clinics, I hereby authorize the Harvester Christian Academy staff, school official, program director or adult chaperon to arrange for and consent to any necessary medical services. This in no way obligates the director, coach, school official or chaperon for payment of services rendered if such occurs.
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Please type your name here indicating you agree with the above statement(s). *
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