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Poy Numbe
I hereby authorize any medical treatment, which may be advised or recommended by the camp trainers or attending physician while attending the Yellow Jacket Volleyball Camp. I understand that an injury may result from participation in camp related activities. I hereby release Yellow Jacket Volleyball Camp, the coaching staff and trainers, the Georgia Tech Athletics Association and the Georgia Institute of Technology from any and all liability, claims, demands, actions, and causes of action whatsoever arising out of or related to any loss, damage, or injury, including death, that may be sustained by my child while participating in such camp related activities, or while it, or, or upon the premises where the activity is being conducted. As the parent or guardian of the above listed camper, I also give permission for any emergency medical care that may be required, including transportation and I accept responsibility for the costs.
* I agree to the terms above
* Work/Cell Phone
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* Email (used for confirmation)
* Policy Number
* Health Insurance Co.
* Eve Phone
* Day Phone
* Relationship
* Emergency Contact
Known Medical Conditions
T-Shirt Size
Choose Size
Youth L
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School
* Home Phone
* Parents/Guardians Names
* ZIP
* City
* State
* Address
Year
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Month
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* Date of Birth
* Camper Last Name
* Camper First Name
Yellow Jacket Volleyball Camp
Please fill out the information below. You will be asked to select which camp(s) you wish to attend on the next page. Required fields are noted with an asterisk (*).
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Years Experience
Roommate Request (Overnight Campers Only)
Club Team
* Position
Position 2
Choose One
Middle Blocker
Outside Hitter
Right Side
DS/Libero
Setter
Dont Know
Choose One
Middle Blocker
Outside Hitter
Right Side
DS/Libero
Setter
Dont Know
Allergies to Medication
Coach's Name (Team Campers Only)
Coach's Email (Team Campers Only)
* Grade (in Fall '10)
* Height