EmailMe Form - PACIFIC UNIVERSITY CLINIC REGISTRATION

EmailMeForm

Name *
First Last
Your Mobile Phone *
### - ### - ####
Please input a mobile number that we can text you because sometimes we cannot reach players through email.
Your Email Address *
IMPORTANT: All communication from the Clinic will go to this email address and NOT to your parent's email address. Please make sure that you check YOUR email address for updates from us.
Your Class Year *
Please pick the correct session for your class year.
Height *
Choose your Session. *
Both Sessions are on Wednesday, June 7, 2023 and Head Coach Kip Yoshimura will be running the Clinics.
Primary Position *
Secondary Position *
High School *
GPA *
High School Volleyball Experience & Awards *
List or explain your high school volleyball experience and/or highlights.
Club/School Coach's Name *
Coaches may contact your club coach is they are interested in you.
Club Coach's Telephone *
### - ### - ####
Application Status *
Please indicate whether you (1) have already applied for admission to Pacific University, (2) have been accepted, (3) will be applying, (4) have not applied, (5) are too young to apply, or (5) are simply undecided.
Parent's Name *
Parent's Telephone *
### - ### - ####
Address *

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region
WAIVER & PLAYER AGREEMENT (Below)
All Players must read and sign below to participate in the Showcase.
Waiver & Player Agreement *
Player agrees that by participating in the Clinic she agrees to the terms and conditions in this Waiver & Player Agreement whether she signs below or not and agrees that she would not be allowed to participate in the Clinic unless she agrees to the terms in this Waiver & Player Agreement.
PLAYER acknowledges and agrees that images or video of the Clinic may be taken and be used for promotional purposes and that she may appear in said images or videos.
PLAYER acknowledges, appreciates and agrees that (a) there are certain inherent risks of injury, dangers and hazards associated with participating in the activities at the Clinic and that such risks may be significant, including the potential for serious injuries, permanent injuries and even death, including but not limited to contracting the Covid-19 coronavirus, bodily injury, concussions, strains, broken bones, fractures, ACL/MCL injuries, partial and/or total paralysis, death, or other injuries that could cause serious disability; (b) these risks and dangers may be caused by the negligence of the people running the event and/or persons assisting or participating in the same, the negligence of others, accidents, breaches of contract, the forces of nature or other causes; and (c) risks and dangers may arise from foreseeable or unforeseeable causes including but not limited to, balls striking PLAYER, equipment failing on PLAYER, PLAYER failing or bumping into others, equipment or facilities, PLAYER falling, running, jumping, landing or diving towards or away from a ball, consuming food or beverages at the event, decision making including how long sessions should run and such other risks, hazards and dangers that are integral to running such events.
Despite these inherent risks, PLAYER knowingly and voluntarily assumes ALL such risks, whether known and unknown, whether caused in whole or in part by the negligence of any entities or persons assisting, planning, instructing or working at the Clinic and/or at any concession (collectively referred to as "the Clinic"), and assumes full responsibility for PLAYER's participation at the Clinic. In exchange for PLAYER being allowed to participate in the Clinic, PLAYER, on behalf of herself, her heirs, assigns, personal representatives, legal representatives and next of kin, hereby knowingly and voluntarily COMPLETELY RELEASES everyone associated in any way with the PACIFIC UNIVERSITY Clinic, including but not limited to PACIFIC UNIVERSITY, its coaches, Volley Hawaii, participating Volleyball Clubs, Clinic coaches, volunteer coaches, The USAV Aloha Region, The USAV, any vendors and each of the aforementioned’s respective owners, officers, directors, members, managers agents, employees, organizers, planners; and all volunteers, from any and all claims or lawsuits of any type whatsoever, for all types of damages to include but not limited to contracting the Covid-19 coronavirus, personal injuries, death, property damage, economic damage and all other types of damage to PLAYER and anyone present at the Clinic, arising out of or relating to the Clinic, and also agrees to defend and indemnify the said released parties from all claims or lawsuits that may be brought on her behalf or relating to any injury, death or damage to PLAYER and/or her family members or friends, arising out of or relating to the Clinic.
Refunds shall be given to any PLAYER who is turned away from the Clinic. In all other instances, PLAYER understands that refunds shall only be given upon receipt of a written request with a physician's note certifying any injury on or before the Clinic.
PLAYER (and Parent if Player is under 18) [1] HAS READ, UNDERSTANDS AND AGREES WITH EACH OF THE TERMS OF THIS AGREEMENT, AND SIGNS IT VOLUNTARILY BELOW CONFIRMING THIS AGREEMENT; and [2] AGREES THAT THE SIGNATURE(s) BELOW WRITTEN WITH A COMPUTER MOUSE IS (are) VALID AS VERIFIED BY SUBMITTING THIS AGREEMENT WITH THE ABOVE REGISTRATION.
Player Signature *
Clear
All Players must sign here regardless of age.
Parent or Guardian Signature
Clear
If Player is under 18, a parent or guardian MUST also sign here.

WAIVER & PLAYER AGREEMENT (Below)