Grace College Volleyball Camps | Winona Lake, Indiana€¦ · Created Date: 11/9/2016 1:21:37 PM
VOLLEYBALL CAMPS -...
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MEDICAL INSURANCE INFORMATION Listed is (are) medical condition(s) and allergies the college should be aware of concerning the registered minor child: The college should be aware that the registered minor child is taking the following medications: Please provide your medical insurance information: VOLLEYBALL CAMPS 2018 WAIVER AND RELEASE OF LIABILITY I hereby give my permission as the parent or guardian of the to participate in Youth Class/Camp Activities at Kirkwood Community College. I acknowledge that Participant is physically and mentally able to participate in these activities and programs. I understand there are certain risks associated with those activities and programs, and I assume the risks to Participant associated with those activities and programs. I understand that I am responsible for insurance coverage for Participant. I, as an authorized representative of the participant, understand that participation in Youth Class/Camp Activities is conditional upon execution of this Waiver and Release of Liability. In consideration of permission to participate, I agree to defend, indemnify and hold the College and the Kirkwood Community College Facilities Foundation and all of its departments, trustees, directors, officers, servants, agents, employees and applicable media vendors harmless from any and all claims of libel, slander, invasion of the right to privacy or bodily injury, property damage or other incident whether arising out of participation or otherwise. I accept the above terms and conditions of the Waiver and Release of Liability Parent or Guardian Signature: Date MEDICAL RELEASE If the named minor child is in need of medical attention, as the result of either illness or injury, I do hereby give my permission for Kirkwood Community College to provide or see that the necessary care is provided. Additionally, I give the college permission to submit my medical insurance information to any medical provider caring for the named minor child. REGISTRATION FORM Participant Name Address City, State, ZIP Home Phone Number T-shirt Size (youth) M L (adult) S M L XL Date of Birth Age Grade (Fall 2018) Parent or Guardian Name Email Address Daytime Phone Number Emergency Phone Number Alternate Emergency Contact Alternate Emergency Phone Number CAMP SESSIONS Check camp(s) desired MIDDLE SCHOOL VOLLEYBALL CAMP (entering grades 5–7) CLYO-4300-98754 $125 LITTLE EAGLE VOLLEYBALL CAMP (entering grades 3–4) CLYO-4320-98752 $35 Make check payable to Kirkwood Community College. Mail check and registration to: Kirkwood Community College Continuing Education 6301 Kirkwood Blvd., SW Cedar Rapids, IA 52404
Transcript of VOLLEYBALL CAMPS -...
MEDICAL INSURANCE INFORMATIONListed is (are) medical condition(s) and allergies the college should be aware of concerning the registered minor child:
The college should be aware that the registered minor child is taking the following medications:
Please provide your medical insurance information: VOLLEYBALLCAMPS
2018
WAIVER AND RELEASE OF LIABILITYI hereby give my permission as the parent or guardian of the to participate in Youth Class/Camp Activities at Kirkwood Community College. I acknowledge that Participant is physically and mentally able to participate in these activities and programs. I understand there are certain risks associated with those activities and programs, and I assume the risks to Participant associated with those activities and programs. I understand that I am responsible for insurance coverage for Participant.
I, as an authorized representative of the participant, understand that participation in Youth Class/Camp Activities is conditional upon execution of this Waiver and Release of Liability. In consideration of permission to participate, I agree to defend, indemnify and hold the College and the Kirkwood Community College Facilities Foundation and all of its departments, trustees, directors, officers, servants, agents, employees and applicable media vendors harmless from any and all claims of libel, slander, invasion of the right to privacy or bodily injury, property damage or other incident whether arising out of participation or otherwise.
I accept the above terms and conditions of the Waiver and Release of Liability
Parent or Guardian Signature:
Date
MEDICAL RELEASEIf the named minor child is in need of medical attention, as the result of either illness or injury, I do hereby give my permission for Kirkwood Community College to provide or see that the necessary care is provided. Additionally, I give the college permission to submit my medical insurance information to any medical provider caring for the named minor child.
REGISTRATION FORMParticipant Name
Address
City, State, ZIP
Home Phone Number
T-shirt Size (youth) M L (adult) S M L XL
Date of Birth Age
Grade (Fall 2018)
Parent or Guardian Name Email Address
Daytime Phone Number
Emergency Phone Number
Alternate Emergency Contact
Alternate Emergency Phone Number
CAMP SESSIONS Check camp(s) desired
MIDDLE SCHOOL VOLLEYBALL CAMP (entering grades 5–7) CLYO-4300-98754 $125
LITTLE EAGLE VOLLEYBALL CAMP (entering grades 3–4) CLYO-4320-98752 $35
Make check payable to Kirkwood Community College. Mail check and registration to:
Kirkwood Community CollegeContinuing Education6301 Kirkwood Blvd., SWCedar Rapids, IA 52404
Get ready to sharpen your volleyball skills! Our camp is designed to cover everything from serving and serve receiving, to attacking, blocking, setting and defense—all taught by experienced staff in Kirkwood’s outstanding facility, Johnson Hall.
Participation is limited—register today!
For check in, please report to Johnson Hall, located across from the baseball/softball fields on main Cedar Rapids campus.
MIDDLE SCHOOL VOLLEY BALL CAMPThis camp emphasizes technical training, advanced position specialization for individual skills, along with team concepts and team play. It’s for students entering grades 5–7. Lunch and a T-shirt are included in tuition.
Section #: CLYO-4300-98754Date and Time: July 23–24, 9 a.m.–3 p.m. (Lunch provided.)
Location: Johnson Hall Tuition: $125
LITTLE EAGLE VOLLEYBALL CAMPBeginning skills kids camp, which is open to those entering grades 3–4, is designed for beginning fundamental skill development. This is the perfect camp for those players who are just learning the game. Fun drills and games are used to teach the fundamental skills and basics of volleyball.
Section #: CLYO-4320-98752Date and Time: July 25, 9 a.m.–noonLocation: Johnson Hall Tuition: $35
For more information, contact Lynn Lueck, 319-398-4909 or [email protected].
Register online at www.kirkwood.edu/ce, search Volleyball, or call 319-398-1022 with registration questions.
GET IN THE GAME!WELCOME TO THE EAGLE EMPIRE
COACHESMEET THE
JILL WILLIAMS Head Coach13th season
Holds an overall record of 387-184
A conference record of 113-20
NJCAA National Tournament 7th place finish (2016)
NJCAA National Tournament 7th place finish (2015)
NJCAA National Tournament 9th place finish (2012)
NJCAA National Tournament 8th place finish (2010)
NJCAA Region XI Champions (2010, 2012 and 2015)
28 years of coaching experience
KEVIN GEARY Assistant Coach 4th season
30 years of coaching experience at both the high school and college levels
9 years as Prairie Volleyball Club Director
Kirkwood players will assist with camps.
