Registration Form - Winter 2012

I am registering as a...

Name of Individual/Team Captain * First Last

Email *

Gender *

Age *

Height (Feet, Inches) *

Division of Choice *

Please see website for descriptions of each division. Semi-competitive was previously known as Competitive 2 and Competitive was previously known as Competitive 1 for returning players

Position of Play *

If you are registering as a team/group, please list the full names and emails of your teammates here (or request other individuals you would like to play with):
ex. Amanda Canavan / Amanda@durhamregionvolleyball.com

DRV Waiver *

Yes, I have read and agree by the terms and conditions on the DRV league which can be found on the Registration page & policies and procedures page Yes, I have read and completed the DRV waiver and understand that every member of my team (if you are a team captain) must also complete the waiver.

The DRV waiver can be found on the registration page. And this is to be completed by ALL players (even those who played last session) It needs to be filled out for each session played.

Payment Options *

TEAM FEE - I would like to pay online now via paypal (and I know that there is a $12.00 admin fee) INDIVIDUAL FEE - I would like to pay online now via paypal (and I know that there is a $5 admin fee) I will not be completing payment now and will pay via cash/certified cheque on January 15th I will contact the league coordinator to arrange drop off/mail payment prior to January 15th as the first two options do not work for me

How'd You Hear About Us? *

Please let us know how you heard about us!

Please list any comments / questions here:

Wufoo