Registration

Registration for select 2011/2012 programs can be found below. Registration for other programs will be opened as soon as details are finalized.

NOTE: In order to complete this registration, one must be 18 years of age or older. Otherwise, a parent/guardian must complete this form on the athlete's behalf:

Which program are you registering for?

Select the program: Name that will appear on payment (credit card)

Athlete Information

First Name:
Last Name:
Gender:
Date of Birth: ,
Athlete Email:
Parent Email (if under 18):
Street Address:
City:
Province:
If "Other Province", please specify:
Postal Code:
Home Phone: ( )
School (if applies):
School Coach's Name (if any):
Grade:
Skill Level:
T-shirt size:
Parent Name (if under 18):
Emergency Contact Name:
Emergency Contact Number: ( )
How did you hear about this program?
If "Other", please specify:

Waiver

I, (or the Parent/Guardian of the above named participant if under 18) acknowledge that there are potential risks in physical activity programs. I assume those risks and consent to the proposed participation in this program. I, or any person claiming through me or on my behalf, do hereby release and agree to save harmless the Maverick Volleyball Club and it's officers, members or agents from claims for loss, injury or damage to persons and property while participating in this program or traveling to and from this program.

I understand that the Maverick Volleyball Club gathers personal information about their participants, including name, address, email, telephone number, gender, date of birth and other information to help in the administration of their programs. This information is for the purpose of communications from the Maverick Volleyball Club with regard to programs, events, promotions and sponsorships.

I understand that the Maverick Volleyball Club have the right to take photographs, videotape, or digital recordings of me at their programs, to be used in any and all media. I am aware that, by giving consent, I am permitting the participant's name and image to be posted on the web, provided to the media, and used in publications which can be viewed by anyone who accesses these websites, external media, or publications. I understand that I may withdraw my consent to the collection, use or disclosure of my personal information at any time by contacting the MVC Privacy Officer (info@maverickvolleyball.ca).

I have read and agree to the above:

An email will be sent to you shortly acknowledging your registration and providing you with a copy of the information you provided to us for your records.