Z- 2019 MBVS - Coaches Clinic Registration Z- 2019 MBVS - Coaches Clinic Registration This form provides a record of your registration to the Midwest Boys Volleyball Showcase Coaches Clinic. Upon clicking the Submit button at the end of your registration, you will be redirected to PayPal to complete the processing of your payment. Please note that there is a $2 handling charge for your Paypal payment. There is no requirement for a Paypal account to pay through Paypal. Just fill out the "Paypal Guest Checkout" section to pay with your credit card. Coach Information Coach Name * First Coach Name * Last Current Club or School Please list the club or school where you currently coach (if applicable). Coach Phone Number * Coach Contact Email * Additional Info Provide any additional information here. Waiver of Liability I, individually, plan to participate in this event sponsored by the Advancement Academy. In consideration of the acceptance of this application, I, intending to be legally bound, hereby for myself, my heirs, executors and administrators, waive and release any and all rights and claim for damages I may have against Advancement Academy, the directors, coaching staff, representatives and or assignees, for any and all damages which may be sustained and suffered by me in connection with my association with or entry in this clinic, and which may arise in my traveling to, participating in, or returning from this clinic. I authorize Advancement Academy and its staff to act in the best interest of the applicant, at Advancement Academy’s discretion, in the event of injury to the applicant. By checking YES below, I agree to the Waiver of Liability above * Yes Payment Information Showcase Payment Amount (US $) Cost of the Clinic(s) Paypal Handling Fee Separate handling fee (in US $) for credit card/Paypal transactions Total Cost Total amount (in US $) you will pay Payment Instructions Upon clicking the Submit button, you will be sent to PayPal to complete the transaction. PayPal is a leader in online transaction processing and ensures your transaction is handled securely. Note that Advancement Academy does NOT see your credit card information since the transaction is handled entirely by PayPal. Once you complete your payment through PayPal, payment notification will then come directly from PayPal and serve as your receipt. If you cancel your transaction upon reaching PayPal, you will not receive credit for payment and you must repeat the registration process. Captcha If you are human, leave this field blank.