2013 Volleyball Camp Registration Form

Waiver:

I hereby authorize the staff of Duquesne University to act for me according to their best judgment in any emergency requiring medical attention for the said camper. I hereby waiver and release Duquesne University, its corporations, trustees, employees, students and agents from any and all costs, liability and expense for any personal injuries or illness in any way related to participation in the camp program.

I have no knowledge of any physical impairment that would be affected by the said camper's participation in the camp program. I also understand Duquesne University retains the right to use, for publicity and advertising purposes, photographs of campers participating in the camp program.

I have read the above waiver and accept the conditions for the 2013 Dukes Volleyball Camp.*

* You must check that you accept the waiver to participate.

Registration Information: Camper's First Name:
Camper's Last Name:
Age:
Grade (as of Fall 2013):

Address

City
State
Zip Code

Camps
Hitter Camp (July 19)
Setter Camp (July 20)
Skills Camp -Commuter (July 21-24)
Skills Camp - Overnight (July 21-24)
Roommate preference (for overnight camp only):

Legal Guardian's Name:
Home Phone:
Work Phone:
Email Address:

Emergency Contact:
Emergency Phone:

After completing this online registration form, please send in a $75 non-refundable deposit (make checks payable to Steven Opperman) to:

Duquesne University Volleyball Camp
A.J. Palumbo Center
600 Forbes Avenue
Pittsburgh, PA 15282

**Make checks payable to: Steven Opperman**