Butler Volleyball

There are errors with your form submission. Please review and submit again

Medical Waiver Release and Medical Authorization:   must be digitally signed by a parent or guardian in order for player to participate in camp.

Release of Liability

In consideration of the Butler Volleyball Camps granting the student permission to participate in the Butler Volleyball Tournament, I hereby assume all risks of his/her personal injury that may result from the Butler Volleyball activity. As parent/guardian, I do hereby release the Kansas State Board of Regents, Butler Volleyball and their officers, employees, all agents, all instructors, and all participants in said Butler Volleyball program from all liability, including claims and suits at law or inequity, for injury which may result from the student taking part in Butler Volleyball activities.

Health Statement/Medical Authorization

I do hereby affirm that the applicant is in good health and suffers from no illness, disability or condition that requires the taking of medication on a regular basis unless that condition is disclosed and approved. Furthermore, I have no knowledge of any reason that the applicant cannot participate in vigorous activity. I hereby authorize and give my consent to the health authorities of Butler Volleyball or any licensed physician or athletic trainer to perform upon or administer, without prior consent, any reasonable, necessary medical treatment my student.

I agree to assume all costs related to such treatment. I understand that I will be responsible for any medical or other charges in connection with student's attendance at this camp.

I have read and agreed to the tournament medical release and waiver *
Choose the appropriate age camp. *
Sibling Camper - do you have a sibling registered for camp
* required field