WPVA Summer Volleyball Camp 2026

Volleyball Camp Registration
*Registration and payment deadline May 25th to receive a t-shirt

*Registration and payment deadline June 5th without t-shirt

*10% discount for siblings (coupon code: siblingssave10)

If you have any questions, please contact our directors McKenzie Ash or Stacy Houghton at westpolkvolleyballacademy@gmail.com or 863-308-1609 or 813-417-3363.
Parent/Guardian Information
Parent/Guardian Name

First NameLast Name
Relationship
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Primary Email
*Important camp information and updates will be sent to the email address on file.
Parent/Guardian Name

First NameLast Name
Relationship
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email
Athlete Information
Athlete's Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Athlete's Date of Birth

MonthDayYear
Athlete's Age
Volleyball Experience
If you are registering more than one athlete, please fill out the fields below for each additional athlete.
Second Athlete's Name

First NameLast Name
Athlete's Date of Birth

MonthDayYear
Athlete's Age
Volleyball Experience
Third Athlete's Name

First NameLast Name
Athlete's Date of Birth

MonthDayYear
Athlete's Age
Volleyball Experience
Fourth Athlete's Name

First NameLast Name
Athlete's Date of Birth

MonthDayYear
Athlete's Age
Volleyball Experience
Any Known Allergies?
If yes, please list below:
Any Medications?
If yes, please list below:
Other Known Conditions
*If none, please type N/A
Emergency Contact (other than parent/guardian above)

The person(s) listed below are authorized to pick up my athlete from camp
Name

First NameLast Name
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Name

First NameLast Name
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Relationship
Waivers and Releases
Release statement: The undersigned parent or legal guardian of the athlete/athletes listed above hereby consents and authorizes participation in West Polk Volleyball Academy's Volleyball Camp. I understand that my athlete/athletes will be in drills that require physical exertion and acknowledge that there is a risk of personal injury to my athlete/athletes. In consideration for WPVA accepting the above names athletes into the Volleyball Camp, I do hereby for myself, my spouse, and my athletes forever discharge West Polk Volleyball Academy, its associates, directors, affiliates, and either in law or equity, arising from or as a result of my athlete/athletes participation in WPVA Camp.
Name

First NameLast Name
Signature
Photo/Video Waiver: I knowingly give consent for the release of any photographic images that may be taken during my child’s participation in WPVA'S Volleyball Camp for the use by West Polk Volleyball Acadmey for its publications, promotional materials, social media, advertisement. I hereby grant permission to the rights of my child’s image, likeness and without payment or any other consideration. There is no time limit on the validity of this release nor is there any geographic limitation on where these materials may be distributed.
Name

First NameLast Name
Signature
Any additional notes or requests for the volleyball camp?
Payment Information
Other Payment Types
Mailing Address: 4419 Morgan Creek Pkwy. Lakeland FL 33811 (if paying by check and have siblings take 10% off the total due)

Athlete Registration (only check this box if you are paying electronically, if paying by check please advance to the submit button below)

2 Day Athlete Registration

$65.00 Quantity

1 Day Athlete Registration

$40.00 Quantity

Enter coupon

Total

Payment Methods

Fastlane Checkout

Choose from one of the PayPal options to make your payment.

Contact Info

Payment Info
Should be Empty:

Volleyball Camp Registration

Parent/Guardian Information

Athlete Information

Emergency Contact (other than parent/guardian above)

Waivers and Releases

Payment Information

Athlete Registration (only check this box if you are paying electronically, if paying by check please advance to the submit button below)

Payment Methods