Interested in improving your volleyball skills before tryouts?

Join us for Summer Volleyball Clinic!

Open to all incoming 7^th and 8^th grade girls

Date and Time: August 3^rd – 7^th 4:00-6:00pm

Location: Rice Gymnasium 7550 Seuss Drive

Hosted by: Coach Llorens

Cost: $35, Cash only PLEASE! Payment is due on the 1^st day of camp

Please email Coach Llorens before July 26^th if you are planning to attend. Wllorens@houstonisd.org Cell 832-483-0923.

******No child will be denied participation due to in ability to pay. Limited scholarships are available. Please speak to Coach Llorens if the need arises.******

First and Last Name _________________________________________________

2009/10 grade _____________________________________

Parent/Guardian ___________________________________ Phone ____________

Medical conditions ___________________________________________________

Name and phone of emergency contact ___________________________________

WAIVER & PROOF OF INSURANCE, PICK UP POLICY

I hereby authorize the camp staff to act for me, according to their best judgment, in any emergency requiring medical attention, and hereby wave and release the Llorens Volleyball Camp from any and all liability for any injuries or illnesses that may occur while at camp. I have no knowledge of any medical problem or physical impairment that would effect the above named camper to safely participate in the camp program. I certify that the above named camper is covered by a medical insurance policy in case of injury or illness. All camp participants must be picked up by 15 minutes after the end of camp-any late pick ups will result in immediate disqualification of the camper for all future camp activities.

MEDICAL INS. COMPANY____________________________POLICY #_____________

SIGNED (PARENT/GUARDIAN)______________________________DATE__________