June 26th 28th, 2013

Grade 5-12 $200 (UWC) | $225 (Non-UWC)

Please cross your cheque and make it payable to: BRAINWORKS EDUCATION
Volleyball is a game which requires excellent psychomotor skills and coordination. The Beginner Volleyball Camp would provide students an opportunity to learn the game in a fun and interactive way, encouraging love for the sport.

REGISTER BEFORE 2nd June 2013

United World College Southeast Asia (Dover) 1207 Dover Road Singapore 139654 4 PM 7 PM
For further information, kindly contact: Mr. Hari +65 97801304 hariharan.s@virtus-fitnessgurus.com the.haran@yahoo.com

Participants would be taught the fundamental volleyball skills needed to play the game.
Boys and Girls are welcomed to join the camp.

Sponsored by:

Handouts and goodies are provided to all players.

Its never too late to learn Volleyball!

BEGINNERS VOLLEYBALL CAMP 2013 REGISTRATION FORM

26th - 28th June 2013 $200 (UWCSEA Students)

4pm 7pm
UWCSEA Dover Campus

$225 (Non-UWCSEA Students)

Age Groups: Grade 5 - 12

Please cross your cheque and make it payable to: BRAINWORKS EDUCATION

Sponsored by:

Name: ____________________________________________ Date of Birth: ____________________________

Address: ____________________________________________________________________________________ E-mail address: ______________________________________________________________________________ Age: __________ Last school grade completed: _________________ Male/Female _________

Parent/Guardian(s) Name: _____________________________________________________________________

Home Phone: _________________Work Phone: _____________ Cell Phone: _______________

In case of emergency, contact ___________________________________ Phone: ________________________ Special concerns (allergies, medications, medical conditions, etc.) ____________________________________________________________________________________________ T-shirt size (circle one): Youth Small / Youth Medium / Youth Large / Adult Small / Adult Medium / Adult Large / Adult XL
The applicant understands that risk is inherent in any physical activity and agrees that the coaching team connected with the Volleyball Camp will not be held responsible for any accidents or loss however caused. By registering for a camp I, (the athlete) ________________________________ accept personal responsibility for my participation in any activities and I agree to do so at my own risk. The coaches will not be responsible for any loss, damage, injury or ambulance service in connection with such participation. I, (the parent or guardian) ________________________________ understand that every attempt will be made to contact myself as parent or guardian of the athlete should any emergency medical treatment or services occur. If I am unable to be reached I authorize ________________________________ phone #s _____________________________ to act on my behalf as an emergency contact. In the event that I or my alternate contact can not be reached, I give full consent for any licensed emergency service/medical personnel to provide treatment or service necessary to maintain the health of my child. The camp coaches reserve the right to request any application to withdraw from the camp prior to termination if, in their opinion, the applicant isnt acting in a reasonable manner. We also reserve the right to cancel any session due to any circumstances that are not to the benefit of the applicants. If you require further information call Mr. Hari at +65 97801304 or email: hariharan.s@virtus-fitnessgurus.com / the.haran@yahoo.com Signature____________________________________ Date __________________________