Wattles Park Men's Club - Volleyball Signup

At the Battle Creek YMCA's Multi-Sports Complex

Games from February 21 - March 28, 2009

NAME _________________________________________________________

PHONE NUMBER (primary)____________________________(secondary) ____________________

ADDRESS _____________________________________ZIP CODE 490 ____

CIRCLE PRESENT GRADE:  3   4   5   6   7   8    9  10  11  12   

BIRTH DATE (month/day/year) _______________

SCHOOL THAT YOU ATTEND __________________      CIRCLE:  MALE  FEMALE

QUESTION FOR 7TH AND 8TH GRADERS:

_____ check here if you played Volleyball for your junior high school

PARENTS'/GUARDIANS' NAMES _______________________________________

Email address ___________________________________________

PLEASE CHECK:

_________ Enclosed is my check for $50.  You will receive 1 "WPMC Peel-It Card" that sells for $15.  Selling the card (you keep the money) will make your signup fee $35 (same price as last year)

_________ Enclosed is my check for $45.  You WILL NOT receive a "Peel-It Card."

or ANOTHER OPTION TO COVER THE ENTIRE SIGNUP FEE:

_________ Enclosed is my check for $90.  You will receive 6 "WPMC Peel-It Cards" that sell for $15 each.  By selling the "Peel-It Cards" (you keep the money) my child will play for FREE.

PARENTS' CHECK LIST:

_________ COACH (for my child's team)

_________ ASSISTANT (for my child's team)

_________ CONCESSION WORKER (one time only)

_________ MEDICAL PERSONNEL - Although rarely needed, it's nice to know that there's someone in the stands that might be able to help if an injury occurs. If you identify yourself we'll know that you might be there during the duration of your child's game. If an emergency occurs, we'll be able to contact you. If you are trained for this category, please circle your profession: Doctor, Nurse, Police Officer, Firefighter, E.M.T., or list any other category. Thanks for volunteering.

Please print out and mail this form to:

WPMC c/o Gary Lincoln
13166 11 Mile Road
Ceresco, Michigan 49033

Make all checks payable to "WPMC"

Additional forms are available at the WPMC Web Site http://www.wpmc.net

Return to WPMC Volleyball.