CSSE Volleyball Registration 2019
In order for your student to play, this form MUST be completed by:
6th, 7th and 8th grade - due by May 1, 2019
4th and 5th graders - due by August 16, 2019

2019 Participation Fee - $65.00
Checks payable to St. Eugene Athletic Commission should be dropped off in the school office in an envelope marked Volleyball
Financial assistance/scholarships are available to help cover cost of registration fee if needed. Please contact Mrs. Goldsworthy to request assistance.

Questions? Contact Greg Metz, Volleyball Coordinator at volleyball@steugeneschool.org.

Boys Volleyball - once registration forms have all been received, it will be determined if there are enough players to form an all boys team this year.

Student Last Name *
Your answer
Student First Name *
Your answer
Student Grade *
Student Uniform Jersey Size *
Parent Name *
Your answer
Guardian Type *
Parent Email *
Your answer
Parent Primary Phone Number *
Your answer
Do you have an interest in coaching or assisting?
Parent Name
Your answer
Guardian Type
Parent Email
Your answer
Parent Primary Phone Number
Your answer
Do you have an interest in coaching or assisting?
St. Eugene School Release & Indemnification Agreement
The parent and/or legal guardian of student listed on this document, in consideration of the agreement by St. Eugene School allow my child to participate in the sport listed above, hereby agrees as follows:

That no claim will be made by the undersigned on behalf of myself or on behalf of my child for personal injuries or other losses sustained by my child as a result of my child's participation in the above described sport.

The parent acknowledges that my child's participation in the above described sport may reasonably be considered a dangerous activity. This Agreement is executed by the parent upon the understanding that St. Eugene School will use best efforts in the conduct of the above described sport.

Parental Agreement *
Medical Emergency
In the event of an emergency, do you authorize that necessary medical attention may be given to my child in the event cannot be reached.
Parental Agreement - Medical Emergency *
Parental Signature (type name)
Your answer
Date *
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