Volleyball Madness Late Registration

Parent/Guardian Info
Emergency Contact
Medical Information
Medical Release

In the event that I cannot be reached in an emergency during this activity/league, I hereby give my permission to the physician or dentist selected by Valley Bible Church to hospitalize, to secure proper treatment, and/or an injection, anesthesia, or surgery for my child as deemed necessary. (Select yes below to agree.)

Payment Selection


Billing Address

Payment Information
CLICK THE SUBMIT BUTTON ONLY ONCE! Clicking twice may charge your card a second time.

By attending/participating in this activity/league, I understand that we will be participating in activities and may also be receiving food, beverages, and/or candy at this event. I also understand that photos or video may be taken and used by Valley Bible Church for promotional purposes only, and will not be sold to other parties. While measures are taken to ensure safety, as with any activity or event, there is a risk of sickness or injury. I fully accept this risk and hold harmless from any legal liability, Valley Bible Church and any staff, volunteers, or representatives involved in this activity/league.

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