Manvel Insurance Release Form Applications will not be accepted without completion of this portion of the application . 2016

I, the undersigned, as the parent or legal guardian of Camp the minor child, hereby acknowledge that the above named child is covered by medical insurance as follows: July 18- July 21, 2015

9:00 AM—11:30 AM Insurer: SKILLS CAMP for students entering grades 4th –incoming 9th graders

Company: Manvel High School Manvel 19601 Highway 6 Policy #: Manvel 77578 2016 Volleyball Camp

I, as parent or guardian, hereby give permission for my child to participate in the volleyball camp and acknowledge the fact that he/she is physically able to participate in camp activities. I hereby authorize the camp staff to act for me according to their best judgment in any emergency Make checks payable to: requiring medical attention. I acknowledge that I may be responsible for any cost (through family medical insurance Alvin ISD Athletic Dept. or otherwise) incurred due to sickness or injury to my Memo: MHS Volleyball camp son/daughter. I hereby waive any claim I might have against the camp, director, or the institutions providing the Mail to Susan Kennedy facilities. c/o Manvel High School Volleyball Parent/Guardian Signature: 19601 Highway 6 Camp Director: Manvel, 774 Susan Kennedy Date: [email protected]

This athletic camp follows guidelines set forth by Alvin ISD and the UIL.

2016 Manvel Volleyball Camp Application Secondary Heading 2016 Manvel HS Camp Staff and Instruction Info Camp Director: Name: Volleyball Camp Susan Kennedy Address: Manvel Volleyball Coach Dates: July 18— July 21, 2016 Coach Kennedy is a graduate of Clear Creek HS where she partici- City/Zip: pated in volleyball, , and soccer. In high school, she re- ceived numerous All Tournament Honors and was selected to the Home Phone: Grades: 4th—incoming 9th graders All-District Team 3 years running. She played collegiate volleyball for E-mail Address: Southern Arkansas University team. Coach Kennedy will begin her second season at Manvel High School for the 2016 volleyball season. Place: Manvel High School Gyms Prior to Manvel she spent 5 years at Clear Lake High School where Grade in 2016 - 2017: 19601 Highway 6 she helped lead CLHS to the playoffs all 5 years including a State School for 2016-2017:______Tournament run in 2013. Manvel, TX 77578 Other Manvel Volleyball Staff Members Time: 9:00—11:30 AM (4th-incoming 9th graders) Camp Fee: Manvel Volleyball Players

$90.00 (4th-incoming 9th graders) Camp Instruction will focus on the following: Cost: $90.00 Individual Skills Transition Make checks payable to: Serve Receive Alvin ISD Athletic Dept. Rotation Memo: MHS Volleyball camp Defense T-shirt Information (select one) Communication Return the completed application to: Team Building Youth Small Having Fun Susan Kennedy Youth Medium Method of Payment Youth Large c/o Manvel High School Volleyball **Concession stand on site** Adult Small Check No: 19601 Highway 6 Adult Medium Cash Manvel, Texas 77578 Adult Large

Adult X-Large Late registration and walkups will be on Monday,

July 18th from 8:00 A.M. - 8:45 A.M. To ensure proper t- shirt size make sure you have your form mailed by July Parent/Emergency Contact Name:

8th.

Daytime/Cell Phone Number:

*Please complete the insurance form*