VOLLEYBALL PROSPECT CAMP
FORM DETAILS
ContactId:
Form ID
EventId:
Camp Status
OPEN
CLOSED
CLOSED FORM
Camp roster is FULL!
We not accepting registrations at this time.
If you have questions, please contact Ruth McGolpin at
rmcgolpin@westmont.edu
.
July 11-13, 2025
Camp roster space is limited!
To reserve your spot submit this registration form as soon as possible!
Players must be current 10th, 11th or 12th grade high school or college transfer students.
If you have questions, please contact Ruth McGolpin at
rmcgolpin@westmont.edu
.
STUDENT CONTACT INFORMATION
Athlete's First Name
Athlete's Last
Name
Mailing Address
Mailing City
Mailing State
Please select...
AL
AK
AZ
AR
CA
CO
CT
DE
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
Postal Code
Mobile
Phone
Home
Phone
Email
PARENT INFORMATION
Parent/Guardian First Name
Parent
/Guardian
Last Name
Parent/Guardian Email
Parent/Guardian Mobile
Add Secondary Parent/Guardian Information
SECONDARY PARENT/GUARDIAN
Parent/Guardian First Name
Parent/Guardian Last Name
Parent/Guardian Email
Parent/Guardian
Parent Mobile
ACADEMIC INFORMATION
Current School Name
Grad Year
YYYY
GPA
ACT
SAT
COLLEGE INFORMATION
Student Type
Please select...
First Year
Transfer
Will you enter college as a First Year or as a Transfer?
Term
Please select...
Fall 2025
Spring 2026
Fall 2026
Spring 2027
Fall 2027
Spring 2028
Fall 2028
Spring 2029
Fall 2029
When do you plan to begin your college education?
ROSTER INFORMATION
Primary Position
Secondary Position
Shirt Size
Please select...
XS
S
M
L
XL
Height
Club Team
Weight
Dominant Hand
Right
Left
PAYMENT DETAILS
Camp Preference
$550 for overnight
(includes food and lodging)
$475 commuter/day camper
(does not include food or lodging)
Amount
Name on Card
Billing City
Billing Address
Billing State
Please select...
AL
AK
AZ
AR
CA
CO
CT
DE
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
Billing Zip
Credit Card Type
Please select...
American Express
Discover/Mastercard/Visa
Card Number
MM
YY
CVV Code
LIABILITY WAIVER
Consent for Event Activities and for Treatment
PARTICIPANT
First Name
Last Name
Birth Date
EVENT INFORMATION
Event Name
MEDICAL INFORMATION
Leave blank where not applicable.
Known Allergies
Current Medications
Physical Restrictions
Previous Injuries
Other info that emergency assistance providers should know:
PARENT/LEGAL GUARDIAN
If Participant a minor; preferred contact otherwise.
First Name
Last Name
Email
Mobile Phone
Home Phone
Work Phone
Address
City
State
Zip
MEDICAL PROFESSIONAL
Full Name
Office Phone
Mobile Phone
Pager
AUTHORIZED ADULT
CONTACT I
Full Name
Mobile Phone
Home Phone
Work Phone
AUTHORIZED ADULT
CONTACT II
Full Name
Mobile Phone
Home Phone
Work Phone
Authorization for Medical Care
If an injury or illness requires, in the opinion of the person in charge, urgent medical or dental examination or treatment, I authorize and direct that person (or their agent) to:
a) arrange transportation by car or ambulance to the closest hospital;
b) call the Medical Professional/s named above; and
c) attempt to reach one or more of the other listed contacts.
If a named Medical Professional is unavailable, I authorize any emergency treatment deemed necessary by a medical professional licensed for the required service.
Acceptance of Circumstances & Assumption of Risk
I understand that Westmont College assumes no financial responsibility or legal liability for medical care or ambulance transportation. I also verify that the Participant is in sufficient health to be able to participate in the event identified above. I recognize that all physical activity has some risk of injury.
Image Release
I authorize the use, in future program publications, of biographical, image, video or audio content recorded for or during event activities and include this Participant.
Acceptance of Circumstances & Assumption of Risk
I understand that Westmont College assumes no financial responsibility or legal liability for medical care or ambulance transportation. I also verify that the Participant is in sufficient health to be able to participate in the event identified above. I recognize that all physical activity has some risk of injury.
Image Release
I authorize the use, in future program publications, of biographical, image, video or audio content recorded for or during event activities and include this Participant.
Electronic Signatures
A signed copy of this waiver submitted via this form shall be deemed to have the same legal effect as delivery of an original executed copy of this waiver for all purposes.
SIGNATURE
Parent/Legal Guardian or Participant if over 18
Date
Continue to the next page to confirm and finalize this registration.
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