Print and Bring Individual Copy For Each
Player Attending Camp
Date of last Tetanus Immunization
Any Allergies to medicines?
If so, please list
Any Conditions physicians should be aware of?
Person to notify in case of emergency
Family Health Insurance:
Policy Holder and Policy Number
Company Name and Address
I hereby authorize any actions which may be advised/recommended by a
trainer, physician or other health care provider attending my child
during camp. I acknowledge and understand that my child may
sustain physical illness or injury (minimal, serious or catastrophic),
in connection with this camp. I agree to indemnify and hold
harmless Player's Edge Volleyball, its officers, employees and agents
from and against any claims for personal illness or injury that my
child may sustain during camp, regardless of cause, including
negligence on the part of any person identified above. I also
give Player's Edge Volleyball permission to utilize any photograph of
my child for promotional use. I also understand that my child
must abide by the camp rules and regulations and code of conduct
developed for this camp. I also understand that my child's
failure to adhere to the rules, regulations, and code of conduct may
result in immediate dismissal from camp, with no refund, and I will be
responsible for providing transportation home once I have been
I also understand that by checking the box below on this application
serves the same purpose as my signature and that I understand all
rules and regulations involved.
I have read, understand and explained the
Code of Conduct
regulations to camper.