I want to register for*

Shirt Size*

Current Age*

Player Information

First Name*

Last Name*

Date of birth*

Phone Number*

Address 1*

Address 2

City*

State*

Zip Code*

Email Address*

School Attending

Current Position Played

Parent / Guardian Information

Relationship*

Your First Name*

Your Last Name*

Address 1*

Address 2

City*

State*

Zip Code*

Phone Number*

Emergency Information

Emergency Contact Name*

Emergency Contact Phone*

Agreement / Payment

Waiver: In consideration of being permitted to participate in this event, I, for myself, my heirs, personal representatives or assigns, do hereby release, waive, discharge, and covenant not to sue Crush Volleyball Club, Griffin Elite Sports and Wellness and their officers, employees, volunteers and agents from liability from any and all claims resulting in personal injury, accidents or illnesses (including death), and property loss arising from, but not limited to, participation in the event. I have carefully read this waiver and release, and fully understand its terms.

Also, by checking the box below I understand that I must register with the Pioneer Region via their website(Registration -> New Player) or if returning to USAV (Registration -> Existing Player) and that I must complete the associated medical form and bring it along with me to the Crush Event I have registered for.

The fee for the event must be paid prior to the first day of the event and can be paid by mailing to :

Crush Volleyball Club
PO Box 19
Burlington, KY 41005

Or via PayPal to paypal@crushvolleyball.com. Prior payment holds your spot.

Comments (optional)