Utah High School Volleyball Coaches Association 2007
Web site: www.uvca.org

Select one: New member O Renewal O
Select one: Head Coach O Assistant Coach O

First name: _________________ Last name ________________

School: ____________________ Region: ____ Classification 1 2 3 4 5

Principal: __________________ Athletic Director: ____________________

Mailing Address (School)

Street Address:________________________________________________

City: ________________________ Zip Code: _________________

School Phone: _________________ School Fax: _____________________

School E-mail: _________________________________________________

Mailing Address (Home)

Street Address:________________________________________________

City: _______________________ Zip Code: ________________

Home Phone: __________________ Home Fax: _____________________

Home E-mail: _________________________________________________

Alternate E-mail: _______________________________________________

Send to my: Home O School O

I acknowledge that volleyball or any sporting event is an extreme test of a person’s physical and mental limits and that my participation in a volleyball event can cause potential death, serious injury, or property damage. With a full understanding of the potential risks, I HEREBY ASSUME THE RISKS OF PARTICIPATING OR OFFICIATING IN A VOLLEYBALL EVENT.

I hereby take the following action for myself, my executors, administrators, heirs, next of kin, successors and assigns: a) I WAIVE, RELEASE, AND DISCHARGE from any and all claims or liabilities for death or personal injury or damages of any kind, EXCEPT THAT WHICH IS THE RESULT OF GROSS NEGLIGENCE AND/OR WANTON MISCONDUCT OF PERSONS OR ENTITIES LISTED BELOW, which arise out of or relate to my traveling to and from or my participation in any volleyball event, THE FOLLOWING PERSONS OR ENTITIES: USA Volleyball and its Regional Volleyball Associations, tournament directors, sponsors, and the officers, directors, employees, representatives, and agents of any of the above; b) I AGREE NOT TO SUE any of the persons or entities listed above for any of the claims or liabilities that I have waived, released or discharged herein; and c) I INDEMNIFY AND HOLD HARMLESS the persons or entities mentioned above from any claims made or liabilities assessed against them as a result of my actions.

Membership Fees $25.00 Make checks payable to UVCA membership services.

Due date Sept. 15th 2007

Send Registration and checks to:

Hunter High School
c/0 Pam Olson
4200 S. 5600 W.
West Valley City, Utah
84120