Summer Volleyball Clinic Registration 2025

Registration Fee : $100 per athlete per week

*The clinic requires a minimum of 12 participants and will be capped at a maximum of 28. Once we have 28 registered we will start a waiting list.

Registration Deadline: Wednesday, June 25, 2025 Registrations received after the deadline subject to a $25 late fee and will not receive t-shirt.

The clinic is for 9th through 12th graders (grade entering MHC Academy Fall 2025) and upcoming 8th graders for Week 1.

This form MUST be completed for each participant and payment must be made before the start of the Volleyball Clinic. No exceptions.

Clinic Details

Volleyball Clinic WEEK 1 - Beginner/JV Level Clinic

Monday July 7th through Thursday July 10th (4 days)

5pm-7pm

MHC Gymnasium

Volleyball Clinic WEEK 2 - Advanced/Varsity Level Clinic

Monday July 14th through Thursday July 17th (4 days)

5pm-7pm

MHC Gymnasium

Student Information

Full Name:*

Answer required for "Full Name:"

Grade Entering*

Fall 2025

Answer required for "Grade Entering"

Birthdate:*

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Cell Phone:

No dashes or symbols

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Address

Street Address:*

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City*

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Zip/Postal*

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Home Phone:*

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Parent/Guardian Information

Primary Parent/Guardian Name:*

Answer required for "Primary Parent/Guardian Name:"

Primary Parent/Guardian Email:*

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Primary Parent/Guardian Cell:

Answer required for "Primary Parent/Guardian Cell:"

Secondary Parent/Guardian Name:

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Secondary Parent/Guardian Email:

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Secondary Parent/Guardian Cell:

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Emergency Contact Name:*

In the event either parent cannot be reached.

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Emergency Contact Number:*

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Health Insurance Information

Insurance Provider:*

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Policy #:*

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Company Address:*

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Phone:*

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Are there any medical conditions/allergies that we should be aware of?*

Examples: Asthma, Carries an Epi-pen for Severe Allergies, Seizures, etc.

Answer required for "Are there any medical conditions/allergies that we should be aware of?"

Yes

If yes, please explain below.

Answer required for "If yes, please explain below."

Medical Treatment Authorization and Liability Release

My daughter elects to take part in the Mary Help of Christians Academy Summer Volleyball Clinic. I acknowledge that this is an extracurricular activity in which my daughter is participating voluntarily and understand that there may be some risks of illness or injury (minimal, serious, or catastrophic) in connection with the activity itself and/or transportation to and from the activity. In consideration of my daughter being permitted to participate in the activity, I hereby assume all of these risks and waive any possible claim that my daughter or I might have against Mary Help of Christians Academy athletic programs, Mary Help of Christians Academy, and any employees, agents, or students, in conjunction with our participation in this activity. I further acknowledge that the above individual is covered by health insurance. I hereby agree that I am responsible for all medical treatment, and give permission for my child to receive medical treatment in the event that I am unable to be contacted. I hereby hold Mary Help of Christians Academy and its coaches and their directors and representatives harmless in exercise of this authority. I also give permission for Mary Help of Christians Academy to use photographs taken of my child at the clinic to post online or use of future posters.

I acknowledge that have read and understand the medical treatment & liabilty release statement contained herein and give consent.*

Answer required for "I acknowledge that have read and understand the medical treatment & liabilty release statement contained herein and give consent."

Parent must click here.

Enter Full Name as Signature:*

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Date*

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Week Attending *

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Week 1 $100

Week 2 $100

Both $200 (can attend week 2 if attending week 1 as well)

Payment*

Clinics can be paid by check made out to MHCA, cash in sealed envelope with name or VENMO @MHCA-Athletics (3313) .

Answer required for "Payment"

Check

Cash

VENMO

T-Shirt Size*

Shirts will only be ordered if at least 12 athletes have registered for the clinic by the deadline.

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Adult Small

Adult Medium

Adult Large

Adult XL

Adult 2XL

Other:

Comments/Notes

If other size selected place here. 8th graders include school here.

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Please fix the highlighted areas below before submitting.

Summer Volleyball Clinic Registration 2025