Circle City Volleyball Club: Development Team

Participants' First Name *
Participants' Last Name *
E-mail *
Address *
City *
State
Zip *
Phone *
School *
Grade *
Birth Date *
Shirt Size *
By checking this box, the participant’s parent/guardian affirms having read it. Sponsoring Organization: Capitol Sports Center. In consideration of my involvement under the auspices of the sponsoring organization, I acknowledge and agree that: Participants risk bodily injury, including paralysis, dismemberment and death, as well as loss or damage to property. I knowingly and freely assume all such risks: and I, for myself and on behalf of all my heirs, assigns, and next of kin, hereby release hold and promise not to sue the Capitol Sports Center, its officers, official agents and/or employees, with respect of any and all such injury, paralysis, dismemberment, death and/or loss of or damage to property except that which is a result of gross negligence and/or wanton misconduct.
I have read the above and release, and understand that I have given up substantial rights by agreeing to it.
Parent/Guardian Full Name *

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