Arizona Lutheran Academy

STEP ONE
ENTER INFO
STEP TWO
CONFIRMATION
STEP THREE
RECEIPT

Junior Coyote Volleyball Club 2021

PARTICIPANTS: Girls in Grades 4-8

COST:

$50 — for all six Saturdays

$45 — for any five Saturdays (your choice)

$40 — for any four Saturdays (your choice)

Six Saturday sessions:
August 21
August 28
September 4
September 11
September 18
September 25

TIME:
9:00 am—11:00 am

PLACE:
Arizona Lutheran Academy gymnasium

Club Director
Brad Bode
Arizona Lutheran Academy Varsity Volleyball Coach
Email: Bode@ALAcoyotes.org
Phone: 602-268-8686 ext. 18

One form per child. Choose all of the dates this child will attend.
*Cancellation fee is $5.

Qty

Description

Amount

Total

Registration for all six Saturdays

$50.00

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Registration for any five Saturdays

$45.00

---

(select five from below)

Registration for any four Saturdays

$40.00

---

(select four from below)

Total: $0.00

Select your Saturday Sessions:

August 21

August 28

September 4

September 11

September 18

September 25

Registration Information

Child's Name: *

School: *

Grade (4 - 8): *

T-Shirt Size: *

Parent Information

Parent Name: *

Address: *

City: *

State: *

Zip Code: *

Parent’s Phone (home): *

Parent’s Phone (work/cell): *

Medical Information

Please note any medical conditions or allergies:

Parent/Guardian Permission: Above said child(ren) has my permission to participate in the ALA Junior Coyote Volleyball Club indicated. I hereby take all responsibility concerning my daughter’s physical condition upon entering the ALA Junior Coyote Volleyball Club. I also authorize the staff to seek medical attention for my daughter if needed.

Parent/Guardian Permission: *

Check here to indicate that you have read, understand and agree to the terms of the Parent/Guardian Permission agreement above.

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: *