Jr Volleyball Registration & Payment

Welcome to Mannahouse Jr. Volleyball Program!

This is a fun opportunity to play volleyball and be coached by the HS Varsity players.

PRACTICES: MONDAYS, MAY 8-22 & THURSDAYS, MAY 11-25
Time: 3:15-4:15 pm for 1st, 2nd, 5th and 6th grade.
Time: 4:30-5:30 pm for 3rd, 4th, 7th and 8th grade.

Please register, pay $80 sports fee included in this registration.

"*" indicates required fields

Student/Athlete Information

Student Name*

First Last

Birthdate*

Current Grade*

Select T-shirt Size*

MEDICAL INFORMATION

DOCTOR'S FULL NAME*

DOCTOR'S PHONE*

MEDICAL INSURANCE CARRIER*

MEDICAL POLICY NUMBER*

Do you have any allergies or insect sensitivities your coach should be aware of?

Yes

Please list allergies here*

Parent/Guardian Information

Parent/Guardian Name*

First Last

Parent/Guardian Email*

Parent/Guardian Phone*

Other Parent/Guardian Name

Fill this out if the other parent would like to receive email and texts about your child's team events.

First Last

Other Parent/Guardian Email

Other Parent/Guardian Phone

Consent Information

Documents Read?*

YES, I have read and understand the "Concussion - Private School Information Consent.

Student E-signature*

Parent/Guardian E-signature*

JR VOLLEYBALL PAYMENT & BILLING

JR VolleyBall Sports Fee

Price:

Billing Address*

Street Address City State ZIP Code

Credit Card*

American Express

Discover

MasterCard

Visa

Card Number

Expiration Date

Security Code Cardholder Name

77454

Sports Information

READ: Concussion Private School Information Concent

READ: MCA Athletic Handbook