Registration Form: Charger Volleyball Club
**$25.00 PLACEMENT DAY FEE DUE AT THE DOOR** (cost will go towards club fee)
Name of Player:____________________________________________
Address:__________________________________ City: ____________________Zip Code:____________
Date of Birth: _____________Age:__________
Current School: _______________________________ H.S. Graduation Year:________________
Home Phone #: _________________________
Cell # (Parent/Guardian): ________________________		___________________________
Email (Parent/Guardian):  ___________________________________________________
				PLEASE PRINT CLEARLY
Email (Parent/Gaudian): ___________________________________________________
	                    		PLEASE PRINT CLEARLY
Shirt Size: _________________
Did you play in the 2018 Winter session?_______________
Health Care Provider:_______________________________________ Policy #:________________
Emergency Contact & Phone #:____________________________________________________________
Waiver of Liability:
The applicant for this activity is aware that volleyball is a physical sport and the possibility of injury is present. My child is in good health and has my permission to participate in this club I release Churchill High School, Charger Volleyball Club and its staff from any and all liability that might occur and understand that my insurance will cover any such injury. I authorize the club staff to act for us in the best judgment in any emergency medical attention for my child.
I am also fully aware that playing for Charger VBC will not guarantee that I will make my high school team! Signature of athlete:
Parent/Guardian Signature: ____________________________________________Date:______________
Athlete Signature:____________________________________________________ Date:_____________
MAKE CHECK PAYABLE TO: CHARGER VBC
$150.00 DEPOSIT WILL BE DUE BY THE FIRST DAY OF PRACTICE
Churchill High School
8900 Newburgh Road
Livonia, MI 48150

Questions? Contact: chargervbc@gmail.com 
Placement Days for the Spring Season: March 21 7-9 PM