Sunday, October 17th from 4:30pm-6:00pm at the SEA Gym (2300 Hwy 51 & 138, Stoughton, WI 53589). A full demonstration of the Badger Region membership online registration will be shown to help player’s with online registration. Club information concerning costs, tournaments, coaches, travel, practice will be made available during the meeting.
SATURDAY and SUNDAY, NOVEMBER 13th and 14th @ SEA GYM 18U check in: 2:00pm 17U check in: 2:00pm 16U check in: 7:30am 15U check in: 11:30am 14U check in: 4:30pm 13U check in: 4:30pm 12U,11U,10U,9U,8U
tryout: 2:30pm - 5:00pm You ke page ep this tryout: 2:30pm - 5:00pm o Only f info. send tryout: 8:00am - 11:30am in page two. tryout: 12:00pm - 2:30pm tryout: 5:00pm - 7:30pm tryout: 5:00pm - 7:30pm check in: 2:00pm tryout: 2:30pm - 4:30pm (Sun. only)
MONDAY, NOVEMBER 15th @ SEA GYM <MAISL LEAGUE MAKE-UP TRYOUT> 14U, 13U, 12U
check in: 6:30pm
tryout: 7:00pm - 9:00pm
* this tryout is for players that absolutely could not make either Sat. or Sun. tryouts.
WEDNESDAY, NOVEMBER 17th @ SEA GYM <LAST ROUND OF TRYOUTS> ALL AGES
check in: 6:30pm
tryout: 7:00pm - 9:00pm
* this tryout is for players who are still looking for a club to play with or a second tryout with Capital to fill open spots.
Sports Enhancement Academy (SEA Gym) 2300 Hwy 51 & 138 Stoughton, WI 53589 * if using mapquest, plug in Dovorak Ct.
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copy of your Badger Region membership sheet from the webpoint online registration. copy of USAV medical release form Capital tryout form located below $30 Capital tryout fee For Badger Region Webpoint membership, please go to
www.badgerregionvolleyball.org Dave Bayer / Director = 608 234 8520 Lisa Yunker / Dir. Ops = 262 681 2215
to register online. Click on 2010-2011 membership for full instructions and registration. Badger Region membership fee & Capital tryout fee are separate payments made by the players.
Mailing in your forms and payment ahead of time will speed up you check in process the day of tryouts.
Send this form to Capital Volleyball Academy at 5214 North Autumn Lane, McFarland, WI 53558 along with the $30 tryout fee made out to Capital Volleyball Academy, a copy of your Badger Region Membership Form and a copy of the USAV medical release form.
Last Name: ________________________________ First Name: __________________________________ Address: ________________________________ City: _____________________ St: _____ Zip: ________ Parent(s) email for confirmation: ____________________________________________________________ DOB: _______________ Current Grade in School: _____________ Position(s) Played: ___________________ Club played for last season: _______________________________ Current School: ____________________ Age Group trying out for (circle one): 18U
Tryout T-shirt Size (circle one):
PARTICIPANT RELEASE OF LIABILITY FORM For CAPITAL VOLLEYBALL ACADEMY and its employees & staff (Read before signing) Participant Name: __________________________________________________________________________________________________________________________________ ( Please print name ) In consideration of being allowed to participate in any way in the program, related events and activities, I the undersigned, acknowledge, appreciate and agree that: 1. The risk of injury from the activities involved in this program is significant, including the potential for permanent paralysis and death, and while particular rules, equipment and personal discipline may reduce this risk, the risk of serious injury does exist and, 2. I KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS, both known and unknown, EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASEES or others, and assume full responsibility for my participation; and, 3. I willingly agree to comply with the stated and customary terms and conditions for participation. If however I observe any unusual significant hazard during my presence or participation, I will remove myself from participation and bring such to the attention of the nearest staff immediately and, 4. I, for myself and on behalf of my heirs, assigns, personal representatives and next of kin, HEREBY RELEASE, INDEMNIFY, AND HOLD HARMLESS Capital Volleyball Academy and their officers, officials, agents and/or employees, other participants, sponsoring agencies, sponsors, advertisers, and if applicable, owners and lessons of premises used to conduct the event (RELEASEES), WITH RESPECT TO ANY AND ALL INJURY, DISABILITY, DEATH, or loss or damage to person or property, WHETHER ARISING FROM THE NEGLIGENCE OF THE RELEASEES OR OTHERWISE, to the fullest extent permitted by law. I HAVE READ THIS RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND SIGN IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT. X_____________________________________________________________________________________________________________________________________________________________________ Participant’s Signature Age Date FOR PARENTS/GUARDIANS OF PARTICIPANT OF MINOR AGE / (UNDER AGE 18 AT TIME OF REGISTRATION) This is to certify that I, as parent/guardian with legal responsibility for this participant, do consent and agree to his/her release as provided above of all the Releasees, and for myself, my heirs, assigns, and next of kin, I release and agree to indemnify and hold harmless the Releasees from any and all liability incidents to my minor child’s involvement or participation in these programs as provided above, EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASEES, to the fullest extent permitted by law. X_____________________________________________________________________________________________________________________________________________________________________
Tryout Fee Method of Payment
Use the following USAV age definition chart to decide what age group your child fall under to tryout for: 18 & Under
Born on or after June 16 1992 & enrolled in High School
17 & Under
Born on or after September 1st, 1993
16 & Under
Born on or after September 1st, 1994
15 & Under
Born on or after September 1st, 1995
14 & Under
Born on or after September 1st, 1996
13 & Under
Born on or after September 1st, 1997
12 & Under
Born on or after September 1st, 1998
11 & Under
Born on or after September 1st, 1999
10 & Under
Born on or after September 1st, 2000
I am paying $30.00 by check # ________________ sent with this form and made out to Capital Volleyball Academy.
I am paying $30.00 by submitting my credit card information:
Exp __________ Sec. Code: ________ Billing Zip Code: ________ Name on the card: ______________________________________ Signature: ____________________________________________