Dan Fisher Volleyball Camps

2015 Dan Fisher Volleyball Camp Registration

Download Camp Brochure

Session *:

General Player Information

First Name *:     Last Name *:


Age *:

Address *:

City *:     State *:     Zip Code *:

Parent Name *:
Parent Email *:
Parent Home Phone:
Parent Cell Phone *:

Player Information School Name *:     Grade (Fall 2015) *:
Primary Position *:     Secondary Position:
Years Experience *:
T-Shirt Size:

Club Team:
Roommate Requested: * overnight camps only
Transportation Needed From Airport?
Emergency Information

Allergies *:

Known Medical Condition(s) *:

Insurance Carrier *:     Policy Number *:
Emergency Contact Name *:     Relationship *:
Emergency Contact Day Phone *:
Emergency Contact Evening Phone *:

Medical Release Form - must be signed and handed in at registration.

* denotes required fields

This is a legally binding release for the above named Minor child (hereinafter referred to as "Participant") executed by the above named Parent or Guardian to Dan Fisher Volleyball Camps (hereinafter referred to as "DFVBCamps"). In this agreement, the terms "I" and "Undersigned" refer to the Participant's parent or guardian. 1.0: The Undersigned herby grants permission to Participant to participate in the DFVBCamps at the University of Pittsburgh in the summer of 2013 ("activity"). The Undersigned further grants permission for Participant to stay overnight in Abbottsford or Carpenter Halls (if applicable) for the duration of the camp session. 2.0: In consideration of the Participant being permitted to participate in the activity, the Undersigned releases DFVBCamps (its employees and agents) from any and all liability, claims and actions not arising from Pitt's casual negligence, that may arise from injury or harm to the Participant or from loss or damage to any property belonging to the Undersigned in connection with this activity. The Undersigned grants permission despite the possible dangers and risks, and despite this Release. The Undersigned understands that DFVBCamps does not require the Participant to take part in the activity. 3.0: The Undersigned submits that Participant is physically able to participate in the Activity. In the event of an emergency, the Undersigned grants permission to DFVBCamps to administer first aid and/or obtain emergency medical treatment for the Participant. The Undersigned agrees to pay all expenses incurred due to any emergency involving Participant in conjunction with the Activity. 4.0: The Undersigned therefore agrees to assume and take on all of the risks, except for those risks specifically created by the casual negligence of DFVBCamps, in any way associated with the Activity. The Undersigned also understands that this Release binds heirs, executors, administrators, and assigns of the Participant. I have read this entire Release; I fully understand it and I agree to be legally bound by its terms. 5.0: The Undersigned grants permission to DFVBCamps to utilize Participants photograph, image, audio and/or video recording which is created by DFVBCamps during Participant's participation in the Activity.