Agility and All Skills Clinic Registration

Females ages 9-15 (skill level separated by courts)

1:8 ratio of athletes to coaches for quality instruction and touches
Agility and All Skills Clinic Registration

(Out of Systems, Hitting, Emergency Moves) June 17, 2026 * 5:00pm-7:00pm * LCS Gymnasium
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.
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
Any Known Allergies?
If yes, please list below:
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
Payment Information
Other Payment Types
Mailing Address: 4419 Morgan Creek Pkwy. Lakeland FL 33811
Athlete Registration (only check this box if you are paying electronically, if paying by check please advance to the submit button below)
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Athlete Registration
$45.00

Total

$0.00
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Agility and All Skills Clinic Registration

Parent/Guardian Information

Athlete Information

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