(15U-18U) Momentous VBC 2017/18 Girls Tryouts
Please fill out this form to register your daughter for tryouts.
Which Tryout are you registering for? (Check All That Apply)
Make-up Tryout (All Ages) - Monday, August 14th (6pm-8pm)
Make-up Tryout (All Ages) - Sunday, August 20th (6pm-7pm)
Athlete's Cell Phone: (if applicable)
Athlete's Email Address: (if applicable)
Athlete's Date of Birth (Mo / Day / Year, i.e. 12/09/2002
Athlete's Age Division:
Please make a selection
18 & Under (Players born on or after September 1st, 1999)
17 & Under (Players born on or after September 1st, 2000)
16 & Under (Players born on or after September 1st, 2001)
15 & Under (Players born on or after September 1st, 2002)
14 & Under (Players born on or after September 1st, 2003)
13 & Under (Players born on or after September 1st, 2004)
12 & Under (Players born on or after September 1st, 2005)
11 & Under (Players born on or after September 1st, 2006)
Athlete's Grade in School for 2017 - 2018:
Please make a selection
12th Grade (2018)
11th Grade (2019)
10th Grade (2020)
9th Grade (2021)
8th Grade (2022)
7th Grade (2023)
6th Grade (2024)
5th Grade (2025)
Athlete's Position: (Check All That Apply)
Opposite/ Right Side
Libero / Defensive Specialist
Open to all positions
Please make a selection
Athlete's T-Shirt Size:
Please make a selection
Youth XS (2/4)
Youth Small (6/8)
Youth Med. (10/12)
Youth Large (14/16)
Please make a selection
More than 5 Years
High School you currently attend:
Club Athlete Played for last year:
Parent 1 Name: (Primary Contact)
Parent 1 Cell Phone: (Primary Contact)
Parent 1 Email Address: (Primary Contact)
Parent 2 Name: (Secondary Contact)
Parent 2 Cell Phone: (Secondary Contact)
Parent 2 Email Address: (Secondary Contact)
Address Line 2
State / Province / Region
Postal / Zip Code
Antigua and Barbuda
Bosnia and Herzegovina
British Indian Ocean Territory
Central African Republic
Democratic Republic of the Congo
Republic of the Congo
Papua New Guinea
Saint Kitts and Nevis
Saint Vincent and the Grenadines
Sao Tome and Principe
Trinidad and Tobago
United Arab Emirates
United States Minor Outlying Islands
Virgin Islands, British
Virgin Islands, U.S.
Notes and Comments: please enter notes for special circumstances or comments to our staff here. For instance, does your daughter have a specific food allergy or medical condition we should be aware of?
Waiver, Release of Liability and Consent
PLEASE READ CAREFULLY – THIS AGREEMENT AFFECTS IMPORTANT LEGAL RIGHTS
This Waiver, Release of Liability and Consent Agreement (collectively, the “Agreement”) sets forth the terms and conditions of your participation in any and all activities and events conducted by, and/or related to MMTSC VBC, LLC., “Momentous Volleyball Club” (collectively, the “VBC”), and the Momentous Sports Center, LP (the “MSC”) and its indoor sports facility located at 14522 Myford Rd., Irvine, CA 92606 (the “Facility,” and/or “Facilities”). In this Agreement, “you” means an adult participant or the parent/guardian responsible for, and legally authorized to contract on behalf of, a minor participant of any activity or event hosted by, or affiliated with, VBC or MSC.
THEREFORE, in consideration of being permitted to participate in any VBC or MSC activity or event, whether at the Facility or elsewhere, in any manner, including but not limited to active or passive participation in, and travel to and from, events and activities of the VBC or MSC, and for other good and valuable consideration, the receipt and sufficiency of which is hereby acknowledged by all parties this agreement with intent to be legally bound hereby, you, for yourself, your guests, your personal representatives, heirs, executors, next of kin, and assigns, do hereby agree and:
Acknowledge that you are familiar with the sport in which you will be participating and that you understand the rules governing said sport and the importance of following these rules, both for your own safety and the safety of those around you.
Covenant that before participating in sports or related activities of any kind, you will inspect the Facilities and the equipment to be used. If you reasonably believe or find anything to be unsafe at any time before or during your participation, you will immediately advise your coach or a VBC or MSC manager of any such unsafe condition(s) and you shall refuse to participate any further.
Acknowledge and understand that you will be engaging, voluntarily and by your own free will, in a contact sport that might result in serious injury, including permanent disability or death, and severe social and economic losses due to, not only your own actions, inaction or negligence, but also to: the action, inaction or negligence of others; the rules of the sport in which you are participating; and/or, conditions of the Facility or other premises and any equipment used therein. Further, you acknowledge that there may be other risks not known or reasonably foreseeable to you at this or any future time. You also certify that you have consulted with your or your minor participant’s physician regarding any condition that could pose a risk to participation in any VBC or MSC related activities.
Acknowledge that you are fully aware of and understand the risks involved in the sport in which you are voluntarily participating, and that you assume such risks and accept full personal responsibility for any and all damages, whether incurred presently or in the future, that may result from injury, permanent disability, or death resulting from your participation in said sport. Further, you warrant that will not sue, make a claim, or bring any other legal, equitable or administrative action against any of the released parties (“Releasees”) set forth in the subsequent paragraph, and you acknowledge that neither the VBC nor MSC’s insurance provides coverage for any of your personal injuries or death.
Release, waive and discharge and covenant not to sue the VBC or MSC and/or the VBC or MSC’s: owners, managers, administrators, directors, agents or their respective assigns or successors; coaches, employees or volunteers; event officials; medical personnel; contractors; other participants, or their parents, guardian(s), supervisors and coaches; sponsoring agencies; sponsors; advertisers; and, if applicable, owners, lessors, users and lessees of Facility or other premises used to conduct any event or activity, (each a "Releasee"), from any and all claims, demands, losses, or damages on account of injury, including permanent disability and death, or damage to property, caused or alleged to be caused in whole or in part by the negligence of any Releasee or otherwise to the fullest extent permitted by California law.
Acknowledge that this Agreement expressly includes travel and transportation to and from, or in connection with any VBC or MSC activity or event, in any vehicle, including transportation to and from medical treatment.
Understand that by signing this Agreement, you are agreeing to release and indemnify the Releasees, and hold them harmless from any and all present or future liability, rights of claim, or costs, known or unknown, including but not limited to attorney fees, associated with or arising from your participation.
Understand that, if you are signing this Agreement on behalf of a minor child, you will be giving up the same rights for said minor as you would be giving up for yourself had you signed this document on your own behalf. You further agree that as a parent(s) or legal guardian(s) of a minor participant less than 18 years of age, that you will instruct the minor participant on the meaning of the above warnings and conditions and their ramifications, and that you consent to the minor's participation.
Understand and agree that this Agreement shall be governed by, and construed in accordance with, the laws of the State of California, without regard to conflicts of laws provisions of any jurisdiction; and that any controversy or claim, arising out of or relating to this Agreement, or any agreement relating thereto, or any breach of this Agreement including any claim that this Agreement or any portion thereof is invalid, illegal or otherwise voidable, shall be submitted to arbitration before and in accordance with the Commercial Rules of the American Arbitration Association and judgment upon the award may be entered in any court having jurisdiction thereof. The situs of arbitration proceedings shall be in Orange County, California.
Acknowledge that the waiver by VBC or MSC of a default or breach of any provision of this Agreement shall not operate or be construed as a waiver of any subsequent default or breach of the same or of a different provision. No waiver or modification of this Agreement or of any covenant, condition, or limitation contained in this Agreement shall be valid unless in writing and duly executed by the VBC and .
Acknowledge and understand that this Agreement may be terminated only by:
Acknowledge and understand that any photocopies of this Agreement shall have the same effect as the executed original Agreement, and that this Agreement shall remain effective for ten (10) years after the date set forth on the following signature page.
By signing the signature page attached hereto, you acknowledge and understand the following:
I HAVE READ THE ABOVE WAIVER AND RELEASE OF LIABILITY AGREEMENT, AND UNDERSTAND THAT I GIVE UP SUBSTANTIAL RIGHTS BY SIGNING IT AND, KNOWING THIS, SIGN IT VOLUNTARILY. NO ORAL REPRESENTATIONS, STATEMENTS, OR INDUCEMENTS, APART FROM THE ABOVE AGREEMENT HAVE BEEN MADE TO ME BY ANYONE AUTHORIZED TO MAKE SAID ORAL REPRESENTATIONS, STATEMENTS, OR INDUCEMENTS. THIS AGREEMENT IS INTENDED TO BE AS BROAD AND INCLUSIVE AS IS PERMITTED BY LAW. I ACKNOWLEDGE THAT IF ENGLISH IS NOT MY FIRST LANGUAGE, THAT I HAVE SOUGHT OUT THE ASSISTANCE OF SOMEONE COMPETENT TO SUFFICIENTLY TRANSLATE THIS FORM TO ME.
In order to pay for the goods and services to be provided to me under this Agreement, I hereby authorize VBC and MSC to initiate withdrawals from the payment source I have provided, whether by credit card OR bank account and financial institution named below, and, if necessary, initiate adjustments for any transactions credited/debited in error. This authority will remain in effect until VBC and MSC is notified by me (us) in writing to cancel it in such time as to afford VBC and MSC and the financial institution a reasonable opportunity to act on it. If I elect not to pay the full amount due under this Agreement today, I authorize VBC and MSC to initiate automatic (or installment) payments according to the payment schedule above in order to satisfy my financial obligations under this Agreement.
Authorization and Consent for Medical Treatment
I/we the participant(s) or the parent, parents or legal guardian of the named minor participant, do hereby authorize in the event of an injury, accident, or illness, the VBC and MSC its coaches, team representatives, directors, officers, agents, and/or assignees to seek and obtain care and medical treatment as shall be necessary in their judgment under the circumstances. I/we hereby authorize and direct the above named to consent to any x-ray examination, anesthetic, medical or surgical diagnosis, or treatment and hospital care which is deemed advisable and rendered under the general or special supervision of any member of the medical staff and emergency room staff licensed under the provisions of the Medical Practice Act, of a dentist licensed under the provisions of the Dental Practice Act, and on the staff of any general hospital holding a current license to operate a hospital from the State Department of Public Health or its equivalent. This authorization is effective whether such diagnosis or treatment is rendered at the office of said physician or dentist, at a hospital, or elsewhere. I/we hereby accept responsibility for any expenses related to any treatment and/or treatment-related transportation or other cost, and that under no circumstance shall any such costs be charged to, or claimed from, VBC or MSC. It is understood that this authorization is given in advance of any specific diagnosis, treatment or hospital care being required but is given to provide authority and power on the part of my aforementioned agents to give specific consent to any and all such diagnosis which in the exercise of his or her best judgment may deem advisable. It is understood that effort shall be made to contact the undersigned before rendering treatment to the patient, but that any of the above treatment will not be withheld if the undersigned cannot be reached. I also agree that this authorization to treat shall be valid in any state where such treatment is rendered. I also agree that if English is not my first language that I have sought out someone to translate this form to me and agree that by my signature that I have read and understood the document.
I/we, the participant(s) or the parent(s) or legal guardian(s) of the named minor participant, do hereby give the VBC or MSC and any contractors hired by VBC or MSC, permission to capture and/or produce photographs, videos, film, slides, or other images of me, my minor child or legal ward, and any other guest related to me. I hereby grant to the VBC or MSC, the unrestricted right to copyright any of the above-mentioned materials containing images of me, my minor child or legal ward, or guest, as well as the unrestricted right to use and re-use such material with or without caption information, in part or in whole, in any manner, and for any purpose and in any medium now known of hereinafter invented. These rights include, but are not limited to, the right to publish copy, distribute, alter, license and publicly display these materials and images for editorial, trade, marketing and/or advertising purposes. I also grant to VBC or MSC, and its assigns, the unrestricted right to use and disclose my name in connection with the use of the above materials. I understand and agree that the above materials are the sole and absolute property of the VBC or MSC and thus I will not be compensated for any use of the described materials. I also waive the rights to any and all claims arising out of or in connection with any use of the materials, caption information and images above, including any and all claims for libel, defamation and/or invasion of privacy or publicity, and release and discharge VBC or MSC from any and all liability therefrom. I realize I cannot withdraw my consent after I sign this form and I realize this form is binding on me, my heirs, legal representatives and assigns.
Parent/Guardian Release: I am the parent or legal guardian of the minor listed on the following signature page and I am signing this waiver, indemnification and release of liability agreement on behalf of said minor.
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