Indoor Season (2008-2009) Registration Form

Please complete the following form prior to the first day of play.

Print out the confirmation page and bring it with you to volleyball.

Thank you!

* - Denotes required information!

First Name*

Last Name*

Address 1*

Address 2

City*

State*

Zip Code*

Preferred Phone Number*

(e.g., 617-123-4567)

E-Mail*

Email Subscription
(You will receive monthly email announcements, unless you select "No")

Yes

No

Emergency Contact Name

Emergency Contact Number

(e.g., 617-123-4567)

Highest Level of Play*

Advanced

Intermediate

Recreational

Don't Know / Not Rated

Specialized Position(s)
(Please tell us how comfortable you are playing in the following specialized positions.)

Setter	Middle
No way! So-so... Sure...ok! Bring it on!!!	No way! So-so... Sure...ok! Bring it on!!!

Insurance Purchase*
(Purchase of insurance is required. Which of the following do you plan to purchase?)

CBVA Insurance ($10)

NAGVA Insurance ($35, also covers NAGVA membership fee for the year)

How did you learn about CBVA?

How long have you been playing with CBVA?

year(s)

Print the confirmation page and bring it with you!