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					CENTRAL WASHINGTON UNIVERSITY
                                                                                                                               Athletics
                                                                                                                       400 East University Way
                                                                                                                      Ellensburg WA 98926-7570




2011 WILDCAT
HIGH SCHOOL
VOLLEYBALL
TOURNAMENT CAMP

TOURNAMENT INFORMATION                                                       ENTRY FEE
• Three Divisions — Power (high-level varsity) / Intermediate                $265. Non-refundable, $100 deposit due by May 27.
  (lower-level varsity, high JV) / Challenge (JV, “C” team)                  Balance and T-shirt money due by June 3, 2011.
• Pool play followed by elimination tournament for all teams.                Entries will be accepted on a first-come, first-served basis.
• Play starts at 9 a.m. on the first day and 8 a.m. on the second day         Play starts at 9 a.m. on the first day and 8 a.m. on the second day.
• Up officials provided—each team provides individuals for down               Pools and team schedules will be e-mailed to coaches a week prior
  officials/score flipper/ linesmen                                            to the tournament
• Individual awards for members of championship team in each
  division (maximum 10 players/ coach)
                                                                             FOR MORE INFORMATION, CONTACT
                                                                             Chloe Quirk, Assistant Volleyball Tournament Director
• NEW Individual Skills Clinic Offered before each tournament                400 East University Way, Ellensburg, WA 98926-7570
  on June 16-17, and June 19, 2011 (see Skills Clinic Registration)          Office: 509-963-1907       E-mail: quirkc@cwu.edu




                         CWU is an AA/EEO/Title IX Institution. Persons with disabilities may request reasonable accommodation
                            by calling the Center for Disability Services at 509-963-2171 or e-mailing CDSrecept@cwu.edu.
                                                                        WILDCAT
                                                                      HIGH SCHOOL
                                                                      VOLLEYBALL
                                                                   TOURNAMENT CAMP
                                                                   APPLICATION FORM
                                                                                       CAMP DATES:




School Name ____________________________________________       Each participant is required to bring a CWU HEALTH/
(Please type or print)
                                                               EMERGENCY INFORMATION FORM to the tournament.
Coach’s Name ___________________________________________       Forms are available online at: www.wildcatsports.com. All
                                                               Central Washington University (CWU) campers are required
Coach’s Mailing Address ___________________________________
                                                               to provide a non-returnable physical fitness statement from
City __________________________ State ______ Zip ___________   their physician, a medical release, and proof of their own medical
                                                               insurance prior to their participation in the CWU Camp.
Office Phone Number (_________) __________________________
(Please include area code)
                                                               CAMPERS WILL NOT BE ALLOWED TO PARTICIPATE
Home Phone Number (_________) __________________________       WITHOUT THESE FORMS.
(Please include area code)

E-mail __________________________________________________      The CWU athletic training staff will be on duty during the camp
TOURNAMENT:                                                    sessions and on call throughout the day.
 Saturday, June 18 - Sunday, June 19 (up to 35 teams)
 Monday, June 20 - Tuesday, June 21 (up to 20 teams)
DIVISION (see tournament information for description):         Official Tournament T-shirts can be pre-ordered for a reduced
 Power (Upper)     Intermediate      Challenge (Lower)         rate at $15 each. Please mark the number and sizes you will need
                                                               and send the total amount with your balance. Tournament shirts
TENTATIVE ROSTER:                                              will be sold at the tournament.
 1. ______________________________________________________
                                                               __________________________________________________________
 2. ______________________________________________________     Sizes     No. of shirts    Total amount due ($15 each)
 3. ______________________________________________________     __________________________________________________________
                                                               S
 4. ______________________________________________________     __________________________________________________________
 5. ______________________________________________________     M
                                                               __________________________________________________________
 6. ______________________________________________________
                                                               L
 7. ______________________________________________________     __________________________________________________________
 8. ______________________________________________________     XL
                                                               __________________________________________________________
 9. ______________________________________________________
10. ______________________________________________________     Make entry/T-shirt fee checks payable to:
                                                               Central Washington University Athletics
Deposit $________________
                                                               Return forms and deposit to:
Coach’s Signature _________________________________________    Mario Andaya, CWU Volleyball Tournament Director,
                                                               400 East University Way, Ellensburg WA 98926-7570.
Date ____________________
                                                                 GENERAL INFORMATION AND FEES
CENTRAL WASHINGTON UNIVERSITY
CENTRAL WASHINGTON UNIVERSITY                                    Elite Prospect Clinic is $125 (includes lodging, three meals,
                                                                    and T-shirt)
                                                                 Complete Skills Clinic is $50 (includes a T-shirt)
                                                                 Middle School Clinic is $40 (includes a T-shirt)
                                                                 DESCRIPTION
                                        Athletics                Elite Prospect Clinic — Learn training techniques and NCAA
                                400 East University Way           recruiting rules that will help you prepare for the college level.
                               Ellensburg WA 98926-7570           Evaluations will be given after the clinic.
                                                                 Complete Skill Clinic — Fundamental and volleyball fitness
                                                                  training will be taught with various drills and games. Individual
                                                                  and team strategies will be taught in team competition.
                                                                 Middle School Clinic — For ages 5th through 8th grade. Learn
                                                                  fundamental skills and fun games to improve overall skill.
                                                                 PHYSICAL AND INSURANCE
                                                                 All CWU clinic participants are required to provide a
                                                                 nonreturnable physical fitness statement from their physician, a
                                                                 CWU Camper Health/Emergency Information Form, and proof
                                                                 of their own medical insurance prior to their participation in the
                                                                 CWU Clinic. Individuals will NOT be allowed to participate
                                                                 without properly completed forms. The CWU athletic training


2011 WILDCAT                                                     staff will be on duty during sessions and on-call throughout the day.
                                                                 TIMES

HIGH SCHOOL
                                                                 Elite Prospect Clinic, June 16 — Check-in 2:30 p.m.,
                                                                 Session I 3:00 p.m., Dinner 5:00 p.m, Session II 6:00 p.m.
                                                                 June 17 — Breakfast 8:00 a.m., Session III 9:00 a.m.,


VOLLEYBALL
                                                                 Lunch at noon, Recruiting Session 1:00 p.m., Session IV 3:00 p.m.,
                                                                 Final Session 6:00 p.m., concluding at 8:00 p.m.
                                                                 Complete Skill and Middle School Clinic—Check in at 2:30 p.m.

INDIVIDUAL                                                       Each clinic will run from 3:00 p.m. to 9:00 p.m. with an hour
                                                                 dinner break at 5:00 p.m.



SKILLS CLINIC
                                                                 WHAT TO BRING
                                                                 T-shirt, shorts, athletic court shoes, knee pads, towel, water bottle,
                                                                 and meal or snack for dinner. Please do not bring valuables to camp.
                                                                 FOR MORE INFORMATION, CONTACT
                                                                 Chloe Quirk, Assistant Volleyball Tournament Director
                                                                 400 East University Way, Ellensburg, WA 98926-7570
                                                                 Office: 509-963-1907       E-mail: quirkc@cwu.edu




    WILDCAT HIGH SCHOOL VOLLEYBALL INDIVIDUAL SKILLS CLINIC
                     REGISTRATION FORM
                                                          CLINIC DATES:


                                                                  Clinic attending:        June 16-17, 2011 (Elite Prospect)
Name ____________________________________________________                                  June 17, 2011 (Complete Skill)
(Please type or print)
                                                                                           June 19, 2011 (Complete Skill)
Daytime Telephone (________) ______________________________
(Please include area code)                                                                 June 21, 2011 (Middle School)

E-mail Address ____________________________________________       Make check payable to:
                                                                  Central Washington University Athletics
Mailing Address ___________________________________________       Return registration form, CWU Camper Health/
City _____________________________________________________        Emergency Information form, and fee to:
                                                                  Mario Andaya, CWU Volleyball Tournament Director,
State ________________________________ Zip _________________      400 East University Way, Ellensburg WA 98926-7570.
                       CWU HEALTH/EMERGENCY INFORMATION FORM FOR CWU SPORT CAMPS
                                  WILDCAT HIGH SCHOOL VOLLEYBALL TOURNAMENT CAMP AND SKILLS CLINIC
Check dates that apply:
                                    June 18-19—Tournament Camp I                       June 20-21—Tournament Camp II
    June 16-17—Elite Prospect Clinic     June 17—Complete Skill Clinic                 June 19—Complete Skill Clinic June 21—Middle School Clinic

   THIS FORM AND A VALID PHYSICAL FITNESS STATEMENT MUST BE PROPERLY SIGNED AND RETURNED BEFORE THE FIRST DAY OF CAMP.
                              Students will not be allowed to participate without properly completed and signed forms.


Participant’s Name ___________________________________________________              I, the undersigned, individually and as a parent/guardian of
(Please print)
                                                                                    ________________________________________________________ (participant),
Address ____________________________________________________________                a minor, ask that he/she be admitted to participate in the sports camp
                                                                                    sponsored by Central Washington University.
City _________________________________ State _______ Zip _____________
                                                                                    I am fully aware of the safety risks of participating in this activity.
Birth Date ____________________ Phone (______) _______________________              I acknowledge and accept the risks and I understand that CWU cannot
                   (Month/Day/Year)        (Area Code)
                                                                                    guarantee my child’s safety. I state to you that I am not aware of any
Camp Dates ________________________________________________________                 physical condition that would limit my child’s participation in this activity.
                                                                                    I understand that it is my responsibility to let you know if my child has any
                                                                                    condition that would limit his/her ability to safely participate in this activity.
DOES YOUR CHILD HAVE:                                                               In exchange for my child being allowed to participate in this activity, and to
                                                                                    the fullest extent permitted by law, I hereby waive and release—and further
Allergies        Yes   No If yes, list. ______________________________________      agree to indemnify, defend, and hold harmless Central Washington University
                                                                                    and its trustees, officers, agents, employees, and volunteers from and against—
____________________________________________________________________
                                                                                    any and all liabilities, claims, costs, expenses, injuries, and or/losses that I or
                                                                                    my minor child may sustain as a result of my child’s attendance at the sport
Chronic illness, such as heart condition, asthma, epilepsy, diabetes, etc.          camp, or in the course of competition and/or activities held in connection
                                                                                    with the sport camp.
  Yes       No If yes, list._______________________________________________
                                                                                    I hereby give consent for medical treatment and agree to assume all
____________________________________________________________________                responsibility for payment of medical bills and expenses. Furthermore,
                                                                                    I will be responsible for filing all claims with all insurance companies. You
Has your child had any injuries and/or operations during the past year?             have my permission to release a copy of this form and the personal insurance
                                                                                    information below to any medical provider treating my child.
  Yes       No If yes, list type and dates. _________________________________
                                                                                    I also give permission for my child’s photograph to appear in promotional
____________________________________________________________________                material regarding future camps.

                                                                                    Signature of
Has your child’s physical activity been restricted during the past year?            Parent/Guardian___________________________________ Date _____________
  Yes       No If yes, list reasons and duration. ____________________________
                                                                                    ____________________________________________________________________
                                                                                    (Please print name and relationship to participant)
____________________________________________________________________

                                                                                    IN CASE OF EMERGENCY, NOTIFY:
Is your child taking any medications?     Yes     No If yes, why?_____________
                                                                                    Name ______________________________________________________________
____________________________________________________________________                (Please print)

Name of medication(s) and dosage(s). __________________________________             Relationship ________________________________________________________
____________________________________________________________________                Address ____________________________________________________________
                                                                                    City _________________________________ State _______ Zip _____________
Has your child ever taken any sulfa drugs?      Yes      No
                                                                                    Phone: Work (______) _________________ Home (______) __________________
                                                                                                     (Area Code)                          (Area Code)
Has your child had adverse reactions to any drugs?       Yes   No
                                                                                    Family Physician ___________________________ Phone (______) ____________
                                                                                                                                                (Area Code)
If yes, list drug(s) and reaction(s): ______________________________________
                                                                                    Medical Insurance ___________________________________________________
____________________________________________________________________
                                                                                    Name of Insured ____________________________________________________
Date of last tetanus immunization: _____________________________________            Policy/Group # _____________________________________________________


                                                          Coaches: Please make copies for each participant.

				
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