Z - 2019 3N Clinic Registration This form provides a record to Advancement Academy to register for Summer Clinics at N3. It also provides the option to make your payment by credit card through Payapl or via check. If choosing to pay via Paypal, it will redirect you to PayPal to complete the processing of the payment. Please note that there is a 4% handling charge when paying through Paypal. Those wishing to pay by check, should select that choice and submit their payment to the club promptly. Player Information Athlete Name * First Athlete Name * Last Athlete Grade * Grade 4 Grade 5 Grade 6 Grade 7 Grade 8 Enter grade of athlete for Fall, 2019 Contact Information Contact Name * First Contact Name * Last Contact Phone Number * Contact Email * Additional Info Provide any additional information here. Available Clinics Select all clinics you plan to attend; $20 per session 12 and Under Beginner Skills Clinics Tues, June 4, 6:00pm - 7:30pm Tues, June 11, 6:00pm - 7:30pm Tues, June 18, 6:00pm - 7:30pm Tues, July 9, 6:00pm - 7:30pm Tues, July 16, 6:00pm - 7:30pm Tues, July 23, 6:00pm - 7:30pm June 4 - Beginner June 11 - Beginner June 18 - Beginner July 9 - Beginner July 16 - Beginner July 23 - Beginner 13/14 Middle School Advanced Skills Thurs, June 6, 6:00pm - 7:30pm Thurs, June 13, 6:00pm - 7:30pm Thurs, June 20, 6:00pm - 7:30pm Thurs, July 11, 6:00pm - 7:30pm Thurs, July 18, 6:00pm - 7:30pm Thurs, July 25, 6:00pm - 7:30pm For rising 7th and 8th graders June 6 - MS Advanced June 13 - MS Advanced June 20 - MS Advanced July 11 - MS Advanced July 18 - MS Advanced July 25 - MS Advanced Waiver of Liability I, individually and as the parents(s) or guardian(s) of athlete named above, a minor, ask that he/she be admitted 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 (and the above named athlete) in connection with my association with or entry in this class(s), and which may arise in my traveling to, participating in, or returning from this class(s). Parent(s), guardian, 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 Specify payment method * Payment via Paypal (additional 4% handling charge) Payment via Check Clinic 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 If you selected "Payment via Paypal", 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 pay via check or through our Club Payment tab on the website. If you selected "Payment via Check", please make your check payable to Advancement Academy and mail to the following address: Advancement Academy Volleyball Club 459 Orange Point Drive, Suite C Lewis Center, Ohio 43035 Captcha If you are human, leave this field blank.
