Wattles Park Men's Club - Volleyball Signup

At the Battle Creek YMCA's Multi-Sports Complex

Games from February 24 - March 28, 2018

NAME _________________________________________________________

PHONE (primary)________________________(secondary) _______________________

ADDRESS _____________________________________ZIP CODE 490 ____

CIRCLE PRESENT GRADE:  3   4   5   6   7   8   

BIRTH DATE (month/day/year) _______________

SCHOOL THAT YOU ATTEND __________________      CIRCLE:  MALE  FEMALE

PARENTS'/GUARDIANS' NAMES _______________________________________

Email address ___________________________________________

PLEASE CHECK:

_________ Enclosed is my check or money order for $55. 

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 available to help if an injury occurs. If you identify yourself and an emergency occurs, we may contact you. Please circle your profession: Doctor, Nurse, Police Officer, Firefighter, E.M.T., or list any other category.

Please print out this form, make checks ($55) payable to "WPMC" and mail to:

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

Return to WPMC Volleyball