Rec Volleyball Registration

A volleyball on a wooden court with line markings.

DUE AUGUST 18th 2025

3rd-6th Grade

Please download form and bring into office or pay online.

Questions? Call Emily Johnston at 308-650-0749

Vball Reg Form 2025.docx

***If you have more than one child that you have to register, please bring the form into the office. We DO NOT have the option to change the price of the online pay scale. It is $0 if you pay online no matter what. It is $55 for two children when you bring form into office.

$30

Contact Information

Child's First Name (required)

Child's Last Name (required)

Street Address (required)

City (required)

Child's Birthday (required)

Age (required)

School Grade (required)

Guardian #1 Name (required)

Guardian #1 Phone Number (required)

Email Address (required)

Guardian #2 Name (if does not apply put N/A)

Guardian #2 Phone Number (if does not apply put N/A)

Email Address

Skill Level (required)

T-Shirt Size

Youth T-shirt Sizes (For the Child only, if Not Applicable please select N/A) (required)

Adult T-shirt Sizes (For the Child only. If you selected a Youth Size please select N/A for this option.) (required)

List any Medical Problems/Allergies (required)

I, the undersigned parent of ____________________________(Player’s name) recognize the possibility of physical injury associated with volleyball, hereby release the Worland Recreation District, its officers, league coaches, organizers, referees and all associated personnel against ANY claim by or for the registrant as a result of the registrant’s participation in the program. As the parent or legal guardian of the above-named player, I hereby give consent for emergency medical care prescribed by a duly licensed Doctor of Medicine or Doctor of Dentistry. This care may be given under whatever conditions are necessary to preserve the life, limb, or well-being of my dependent.

Your Signature (required)

Confirm e-Signature

Review Electronic Records and Signatures Policy (required)

Read our Electronic Record and Signature Disclosure

I agree to use electronic records and signatures

COACHES NEEDED. Volunteer coaches required. If you are willing to coach please indicate below. If you are selected as a coach your registration fee will be refunded. If we don’t have enough coaches that means more players per team and less playing time. Only your own child may be requested for your team. Please make checks payable to Worland Soccer Association. (required)