NCVA Fall Competition Payment:

To register players:

Click on the "Form for Player Registration" button below, then
Complete and submit the following form for each player that you are registering. You can submit multiple registrations. Once the form is submitted, you will not be able to return and edit the information.
Proceed to the "Payments / Financial Aid" section below to pay for each registration, or you can mail a check to:

Albany Berkeley Volleyball
1005 Talbot Avenue
Albany, CA 94706

Player Registration Fall 2018

PLAYER INFORMATION

Player Name

First Name

Last Name

Registering for Class

Please select the class for which you are registering a player. Note that there is a discount in the Intermediate/Advanced class for multiple players in a family. There is no discount for the Beginners class.

Player Birthdate

YYYY

Player gender

Experience

Briefly list relevant volleyball experience.

School during season

High School Graduation Year / Grade

Select the year player is expected to graduate high school.

Participate in NCVA Youth League or Fall Competition?

ABV may participate in the NCVA Youth League / Fall Competition for older players if enough players are interested. These leagues are on Sundays on Oct. 14 & 28, Nov. 18, & Dec 9 and last most of the day. The additional total cost for Youth League is $120/player, $170 for Fall Competition. Only respond "Yes" if your player is committing to play. Please do not register your player with NCVA until ABV knows if there are enough interested players to field a team. Further communications will follow.

Player T-shirt size

EMERGENCY MEDICAL INFORMATION

Emergency Contact

First Name

Last Name

Emergency Contact Phone

(###)

###

####

Emergency Contact Alternative Phone

(###)

###

####

List any medical conditions/allergies

List any medical conditions or allergies. "None" if Not Applicable.

Player's Physician

First Name

Last Name

Physician's phone

(###)

###

####

Insurance plan

Player medical number

PRIMARY GUARDIAN INFORMATION

Primary Guardian's Name

First Name

Last Name

Primary Guardian Home Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Relationship to player

Guardian gender

Mobile phone

(###)

###

####

Home phone

(###)

###

####

Work phone

(###)

###

####

Primary Guardian Interest

ABV is a registered 501(c)(3) non-profit and depends on parental support to keep costs down. Please indicate any activities with which this parent/guardian would be interested in participating.

Becoming a parent coach with ABV

Participating on the ABV Board

Other support (please indicate in Comments section)

Not interested in participating at this time

SECONDARY GUARDIAN INFORMATION

Secondary Guardian's Name

First Name

Last Name

Address same as Primary Guardian?

Secondary Guardian Address

Please complete if Secondary Guardian's address is different.

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Relationship to player

Guardian gender

Mobile phone

(###)

###

####

Home phone

(###)

###

####

Work phone

(###)

###

####

Secondary Guardian Interest

ABV is a registered 501(c)(3) non-profit and depends on parental support to keep costs down. Please indicate any activities with which this parent/guardian would be interested in participating.

Becoming a parent coach with ABV

Participating on the ABV Board

Other support (please indicate in Comments section)

Not interested in participating at this time

Comments

Please add additional comments here:

IMPORTANT MEDICAL & LIABILITY RELEASE

Medical and Liability Release Signature

I, the parent/legal guardian of the above named player, a minor, agree that I and the player will abide by the rules and regulations of the Albany Berkeley Volleyball Club, Inc. (ABV) and its affiliated organizations. I, for myself and the player and our respective heirs, administrators and successors, intending to be legally bound, hereby release and indemnify the ABV and its affiliates, the owners and operators of the facilities used for the programs, and their respective directors, officers, employees, agents and representatives from and against all claims, liabilities, damages or causes of action arising out of or in connection with the player's participation in the Programs including, without limitation, player's transportation to/from any Program, which transportation is hereby authorized. I further grant the ABV the right to use player's name, picture and/or likeness in printed, broadcast and other material concerning the Programs provided such use is related to the player's status as a participant in the Programs.

As the parent/legal guardian of the above-named player, I hereby give consent for emergency medical care prescribed by a duly licensed Doctor of Medicine or Doctor of Dentistry. This care may be given under whatever conditions are necessary to preserve the life, limb or well-being of my dependent.

Entering your name below and submitting this form constitutes your electronic signature and full acceptance of this release & waiver.

First Name

Last Name

Electronic Signature Date

YYYY

Payment / Financial Aid

After Registering your player, please make payment below.
If you are in need of financial assistance, please register your player first, then let the club know via the Contacts page.