Beach Volleyball Registration

Beach Volleyball Camp Registration

Please fill in all the required boxes or it will not submit. Payment is due upon registration. Cheques can bemade out to
Quinte Youth Unlimited or paid online at www.QYU.ca/pay. Please contact our office directly with any further questions.

* Indicates required field

Youth Name *

First

Last

Youth Address *

Line 1

Line 2

City

State

Zip Code

Country

T-shirt size *

Youth Experience Level *

Youth Cell Number *

Youth Email *

Grade (as of Sept 2018) *

Allergies? *

Please List Student's Favourite Foods *

Youth Birthday *

Parent/Guardian and Emergency Contact Info

Youth Parent / Guardian Name *

First

Last

Parent/Guardian's Address *

Line 1

Line 2

City

State

Zip Code

Country

Parent Guardian phone *

Parent/Guardian's Email *

Emergency Contact Name & Phone Number(s) *

Other Info

Medical Permission: Do you give your permission to Quinte Youth Unlimited to act on your behalf in the event that your child needs medical attention? *

Media Release: Do you give your permission to Quinte Youth Unlimited to use pictures/videos of your child for the purpose of newsletter, website, print, and any other promotions? *

Does the child have any physical, mental or emotional disability, chronic condition or recent illness which the staff should be aware of or that may require medical attention? *

Name of Parent Completing Registration Form *

How will you be paying the $40 fee? *

Submit Registration Form!