Lake Forest College

STEP ONE
ENTER INFO
STEP TWO
CONFIRMATION
STEP THREE
RECEIPT

Thank you for your interest in the LFC WVB x AZ Storm Clinic. If you have any questions, don't hesitate to contact Head Coach, Melanie Hughes at mhughes@lakeforest.edu.

Details

Date: Saturday, May 16
Check-In: 8:30 a.m.
Clinic Time: 9 a.m. - 12 p.m.
Location: 2915 East Washington Street, Suite 102, Phoenix, AZ 85034

Please choose a camp

Skills Clinic

$75.00

Cost is non-refundable

First and Last Name: *

Birthday *

Address: *

City: *

State: *

Zip Code: *

Email Address: *

Cell Phone: *

Volleyball Club:

High School:

Parent/Guardian Name: *

Parent/Guardian Email: *

Parent/Guardian Phone: *

Emergency Contact: *

Emergency Phone: *

Medication/Allergies/Other medical concerns:

Payer Information

First Name: *

Last Name: *

Billing Address: *

This is the address where your credit card statements are mailed.

Address 2:

City: *

State / Province: *

Zip Code: *

Country: *

Telephone:

E-mail: *

A receipt will be e-mailed to this address.

Waiver: *

Please enter your initials above. I hereby voluntarily give my consent to allow my dancer to attend the Lake Forest College Dance Team Clinic. I have no knowledge of any physical impairment that would prevent my dancer's participation in this camp, as outlined on the website. As part of camp enrollment, I understand that I must have suitable insurance to cover all injuries and/or illnesses my dancer may sustain and I hereby authorize the Lake Forest College Dance Clinic staff to act for me to their best judgment in any emergency requiring medical attention. I hereby waive and release Lake Forest College and its trustees, employees, and agents from any and all liability (except for gross negligence) for any injuries and/or illnesses incurred while at the Lake Forest College Dance Team Clinic

Your Payment Information (Payments by Credit/Debit Card or e-check)

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Expiration Date: *

Name on Account: *

Routing Number: *

Account Number: *