St. Catherine of Siena Athletics - (Cedar Grove, NJ)

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SCS Fall Volleyball Registration for Girls - Grade 5-8

PLAYER INFORMATION

* First Name:

* Last Name:

Street:

City:

State:

Zip Code:

* Birthdate:

Gender:

Grade your Daughter will be in September:

Player Shirt Size:

PARENT/GUARDIAN #1

* First Name:

* Last Name:

* EMail:

Home Phone:

Work Phone:

Cell Phone:

PARENT/GUARDIAN #2

First Name:

Last Name:

Email:

Home Phone:

Work Phone:

Cell Phone:

MEDICAL/EMERGENCY INFORMATION
*** PRIMARY CONTACT ***

* Emergency Contact:

* Contact Phone:

* Relationship to Player:

*** SECONDARY CONTACT ***

Emergency Contact:

Contact Phone:

Relationship to player:

Family Physician:

Family Physician Phone Number:

List any allergy or conditions the coaches need to be award of::

MEDICAL WAIVER INFORMATION

The coaching staff has my permission to apply ice and a bandage to an abrasion as needed.

I/we agree with the above

I/we do not agree with the above

By submitting your payment, you are granting permission for your child to participate in the SCS Volleyball Program. Additionally, please be aware that once the season begins, no refunds will be issued

* indicates required fields

$125 Registration Fee($125)