Required Waiver and Release Form

Participants in Midwest Volleyball Instructors camps should be aware of possible risks that are inherent in the nature of some of these activities. These risks include, but are not limited to the potential for accidents or illness while traveling to and from performance sites, as well as participating in the various activities of the camp. Every attempt is made to minimize the existing risks through the use of proper sports safety practices. However, participants should realize these risks cannot be eliminated entirely. If participants meet minimum physical and mental conditioning and follow safety procedures, the potential for mishaps is reduced.

I, ______________________________, parent or guardian of __________________________, a participant in the Midwest Volleyball camps, do hereby release Midwest Volleyball Instructors, Inc., its coaches and assignees of any responsibility or liability in the case of any personal injury sustained by said member, or damage to property of others caused while participating in the activities of the camp. Such participation will include practice, camp function, competition, and travel to and from all camp activities. This includes travel to and from all camp activities and all non-instructional time between morning and afternoon and afternoon and evening sessions.

I hereby also authorize the coaches and directors of Midwest Volleyball Instructors, Inc., to act for me according to their best judgment in any emergency requiring medical attention. It is understood that the Midwest Volleyball Instructors camps do not provide medical insurance covering injuries of any nature.

Signature of parent/legal guardian _________________Date_____________

Home Telephone_______________Work/Cell/pager____________________

Address_____________________________________________

City _______________________St. _____Zip ______________

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