Co-ed Volleyball Clinic

Watauga County Parks and Recreation’s
4th, 5th, & 6th Grade
CO-ED
Mail or bring to:
Watauga County Parks & Recreation
231 Complex Drive, Boone, NC 28607
(828) 264-9511
FOR OFFICE USE ONLY
Date: _________________
Fee: __________________
Staff: _________________
Receipt #: _____________
VOLLEYBALL
Watauga County Residents Only
REGISTRATION FEE: $45
REGISTRATION DEADLINE:
January 23, 2015
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Child’s Name: _____________________________________________ Home Phone: _______________________________
Child’s Mailing Address: ___________________________________________________ Zip Code: ___________________
Date of Birth: _________ Age (as of 8/31/14): _____ Grade: _____ Gender: _____ Shirt Size: YM YL AS AM AL XL
School Child Attends: ________________ Residing School District: __________________ Custodial Parent: ___________
Father’s Name: _______________________________ Email Address: ___________________________________________
Phone Numbers: (H) ________________________
(W) ________________________
(C) ________________________
Mother’s Name: ______________________________ Email Address: ___________________________________________
Phone Numbers: (H) ________________________
(W) ________________________
(C) ________________________
Would you like to donate $1 (or more) to the Watauga County Parks & Recreation Scholarship Fund? This fund helps others in our
community by allowing the recreation department to offer a reduction in fees or scholarships for many of our programs. For more
information on the scholarship fund, please call 828.264.9511.
YES: Amount _________ NO: _________
Saturday, February 14
Tuesday, February 17
Thursday, February 19
Saturday, February 21
Tuesday, February 24
Thursday, February 26
Saturday, March 1
Circle your preference:
Session ONE
Session TWO
5:30 PM on Weekdays
9:30 AM on Saturdays
6:45 PM on Weekdays
11:30 AM on Saturdays
I, _____________________________________, as parent/legal guardian of participant, ______________________________, hereby give my consent for
participation in the Watauga County Parks & Recreation Volleyball Program. I assume all risks and hazards incidental to such participation, including
transportation to and from the program, and do hereby waive, release, absolve, indemnify and agree to hold harmless Watauga County, its staff, its
volunteers and any sponsoring agency for any claim arising out of any loss or injury that the participant might sustain while engaged in this program. I
understand that Watauga County Parks & Recreation does not provide insurance and is not responsible for the medical condition of the participant. I agree
to the release of photographs of the participant for the promotion of WCP&R. I agree to return or pay for all equipment issued to the participant. I also
agree to abide by the NO REFUND and resident/non-resident participation policies. I am responsible for the listing of any medical conditions, any
limitations or special needs of the participant in the space provided below. I understand the information must be updated when medical conditions change.
___________________________________
________________________
Signature of Parent
Date
Emergency Information: Physician: _______________________________________
Phone: _____________________
Alternative Contact: _______________________________
Phone: _____________________
List any medical conditions, limitations, or allergies: __________________________________________________________
2015
Youth Co-ed Volleyball Clinic
Information Sheet
Registration Fee: $45
Registration Deadline: January 23rd
Equipment:
Participants will receive a clinic t-shirt.
Supplies Needed:
Athletic shoes, knee pads (recommended), & mouth guard (optional)
Registration:
Late registration MAY be accepted after January 23rd with a $20 late fee in addition
to the normal registration cost provided that the registration limit has not been met.
Cost:
$45 per player
Eligibility:
All players must be in the 4th, 5th, or 6th grade and cannot be 13 years of age before
August 31 of the current school year.
Clinics:
Clinics will be held on Tuesday and Thursday evenings
(Session One @ 5:30 PM & Session Two @ 6:45 PM) and
on Saturday mornings (Session One @ 9:30 AM & Session Two @ 11:30 AM).
Instructor:
Rebecca Woolard will be directing the clinics again this year; she has played
volleyball at Mars Hill College for 4 seasons, being a captain on the team for 3 of
those seasons and a leader on and off the court.
Dates:
February 14, February 17, February 19, February 21, February 24, February 26, and
February 28 with possible makeup days scheduled through March 7. Make-up
sessions will be scheduled if a minimum of 6 sessions is not met and only if the
sessions can be scheduled for the make-up days stated above.
Important:
Session availability is on a “first come, first serve” basis; space is limited to 16
participants per class. Sessions may be combined during Session One times if
registration does not facilitate two separate meeting times.
If you have any questions, comments, or suggestions about our programs,
please feel free to contact us at our office during regular office hours.
(828) 264-9511

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