2010 INDIANA VOLLEYBALL CAMPS


IU Volleyball All-Skills Camp

Grades 5-12

July 6-8, 2010, Bloomington, Indiana, at Indiana University

CAMP COSTS

$385.00 - Overnight
$300.00 - Commuter

CHECK-IN/CHECKOUT

- Check-In: 1 p.m. on July 6 at Foster Quad
- Check-Out: 4:15 p.m. on July 8 at Foster Quad



* add 6% for on-line registrations


All Camps Open to All and Any Entrants

FOR REGISTRATION INFORMATION/INQUIRIES:


Registration Note All campers who cancel, including those for medical reasons, will be refunded all pre-paid fees, minus a $50 administrative fee, provided they cancel before June 15, 2010. Cancellations after June 15, 2010, but before the start of camp will be refunded all pre-paid fees minus a $100 administrative fee. No refunds will be issued after the start of camp for any reason.

Please complete the form below and submit camp payment.

 
Camper's Name (Last, First)*
 
Parent's Name*
 
Home Address*
 
City*
 
State*
 
Zip*
 
Camper's Home Phone*
 
Father's Cell*
 
Mother's Cell*
 
Mother's Work*
 
Parent's E-Mail Address*
 
Camper's School*
 
Camper's MS/High School Coach*
 
Grade Entering (as of Sept. '10)*
 
Birthdate (Month/Day/Year)*
 
Roommate Preference (Note: Only one roommate allowed)
 
T-Shirt Size (adult sizes)*
 S
 M
 L
 XL
 XXL
 
<br>How did you find out about IU Volleyball Camp?
 
Other
 

CAMPER OPTIONS*
 Overnight Camper
 Commuter Camper
 


MEDICAL CONSENT FORM
To enable the Health Center of Indiana University and/or other health facilities in Bloomington to provide prompt care to your daughter, we must have a completed Consent Form on file each year. This way, we can help your child without delay in an emergency.
 
Camper's Name (Last, First)*
 
Insurance Company*
 
Name in which Policy is listed*
 
Policy Number/Group #*
 
Insurance Company Phone*
 
Medical Conditions
 
Present Medication (include dosage)
 
Drug Reactions
 
Date of Last Tetanus Toxoid
 
Any Past Illness or other information that would be useful in the event
 
Emergency Name and Phone #s to call if parents can't be reached*
 
Hay Fever*
 Yes
 No
 

Asthma*
 Yes
 No
 

Eczema*
 Yes
 No
 

Insect Stings*
 Yes
 No
 

Other
 

 I grant permission to the Directors, Assistants, or other persons responsible for her care to act on my behalf for said minor in granting permission for evaluation and treatment of medical problems. I understand that should a major medical problem arise, an attempt will be made to notify me by telephone. In the event that I cannot be reached, I hereby give consent to such medical treatment as deemed necessary (including surgery, x-ray examinations and anesthesia to be rendered to said minor by a licensed physician or nurse.)  

 I authorize limited care as follows  
Limited Care Notes
 

 I authorize the IU Volleyball Camp to photograph my child in camp activities for promotional purposes. These photos will be made available on-line for parents to view (with a username and password) and purchase at the conclusion of camp. Information on the website will be distributed at the start and finish of camp.  

* Waiver: I do hereby waive, release and discharge the Indiana Volleyball Camp and the respective staffs, employees, successors, and assigns, of and from any and all rights and claims for damages resulting from injury of my person or property, which may be sustained or suffered by me in connection with my association with or participating in, or arising out of my traveling to or from Indiana Volleyball Camp. We, the parents/guardians, agree to the above waiver and release and we join therein.  

Parent/Guardian Name*
 


PAYMENT OPTIONS
Please select your payment option by indicating a '1' in the quantity field. We need a registration form and consents completed for each participant.

Note: A charge from either Forward Marketing or Hoosiersportscamps.com will appear on your credit card for your on-line registration. However, if the IU Volleyball Camp is cancelled for any reason, refunds must be collected directly from the IU Volleyball Camp, Phone 812-856-3710.
 
Qty 
 $318.00 Commuter Camper Payment in Full

 $408.00 Overnight Camper Payment in Full