Union Volleyball Club | 2012 UNION Derby Tournament

2012 UNION DERBY REGISTRATION

2012 UNION Derby Tournament Registration

Union Derby Tournament

Union Derby Tournament - May 6, 2012
Team: All Ages

Entry Fee: $200.00
Processing Fee: $5.00

Safe and secured online payments via PayPal.

Please fill out the form below to register.
* Required Fields.

Team Information Team Name: *
Team Code: *

Team Rep: *
Email: *

Address: *
City: *

State: *
Zip: *

Phone: * (xxx-xxx-xxxx)
Mobile: * (xxx-xxx-xxxx)

Player Information (9 - 12 players per team) Player Name:
USAV #:
Uniform #:

Optional Agreements Representative Agreement:
By submitting, I hereby state that the above data is correct. Penalty might be rejection of entry or disqualification. The above persons should have carefully read the eligibility rules applying to USA Volleyball. All players of a team are required to be dressed in identical uniforms.

Waiver of Liability:
I, the undersigned parent or legal guardian of the player(s) above, give my permission for the above player(s) to participate in any and all programs, leagues, camps and events offered by UNION Volleyball Club, Inc. I accept all risks associated with participation and understand there is possibility of physical injury or illness. I hereby covenant not to sue and waive, release and discharge any rights and claims for damages that may occur with UNION Volleyball Club, Inc. staff or representatives.

Insurance & Medical Treatment:
By clicking on the checkbox to the right indicates that I have active medical insurance on the player(s) listed above and will maintain coverage while he/she is a participant in UNION Volleyball Club, Inc. I authorize UNION staff or representatives to use standard first aid procedures on the player(s) listed above if deemed necessary in case of an emergency. I understand my medical insurance will be responsible for all expenses which are incurred in relation to any injury sustained during UNION Volleyball Club activity.

Photo Permission:
By clicking on the checkbox to the right indicates I give my permission for UNION Volleyball Club to use photographs of the above player(s) for advertising and promotional purposes on the UNION Volleyball website, Facebook page, fliers, handouts, special offers, and other advertising.

* Required Fields.

Congratulations to UNION 16 Myers Gold Champions at Circle City Invitational [ more info ]

Congratulations to UNION 15 Loftus Gold Champions at Pioneer Regional [ more info ]

Phoenix Fowler signed with Bellarmine University [ more info ]

Congratulations to UNION 15 Adidas, 16 Adidas and 17 Adidas - Bid to the USAV Nationals in Columbus, OH [ more info ]

Congratulations to UNION 14 Brian - Gold in Indy Juniors Tournament [ more info ]

Congratulations to UNION 15 Loftus - Gold at the Holiday Inn Classic [ more info ]

Congratulations to UNION 17 Timberlake - Gold in the Holiday Inn Classic [ more info ]

Congratulations to UNION 17 Timberlake - Silver at the Holiday Inn Classic [ more info ]

Congratulations to UNION 17 Timberlake - Gold in the Crush Spike 'em Tournament
[ more info ]

UNION Discount Fundraising Cards

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OGIO Freezer Cooler Backpack (limited qty)

FINAL SALE - OGIO Freezer Cooler Backpack w/ embroidered UNION logo!

$38.00

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