Participant name     Date of birth   Jan Feb Mar Apr May June July Aug Sep Oct Nov Dec 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989

Participant e-mail  

Mailing address  

City     State  

Home phone    Mobile phone / alternate  

Current school      Year in school   12 11 10 9 8 7

Parent or Guardian     email:  

Parent or Guardian     email:  

Club:     years       Name of club / Positions played   School:     years   Positions played  

List your activities and accomplishments:

Which age group are you trying out for?   Select age group 13s 14s 15s 16s 17s 18s

Which tryout session will you attend?   Select session 13s/14s on Sun, Nov 8th 15s/16s on Thur, Nov 19th 17s/18s on Mon, Nov 23rd

The following are the age definitions for the 2009-2010 club season.

18 and Under Division: Players who were born on or after September 1, 1991 / Players who were born on or after September 1, 1990 and are a high school student during some part of the current academic year

17 and Under Division: Players who were born on or after September 1, 1992

16 and Under Division: Players who were born on or after September 1, 1993

15 and Under Division: Players who were born on or after September 1, 1994

14 and Under Division: Players who were born on or after September 1, 1995

13 and Under Division: Players who were born on or after September 1, 1996

I hereby give permission for my daughter to participate in a tryout for Moxie Juniors, a program within the non-profit Moxie Volleyball organization, for the 2009-2010 season. I also give my daughter permission to play with Moxie Juniors if she is selected and accepts a position with a team. I hereby waive my right and that of my daughter to bring any claim against Moxie Juniors, Moxie Volleyball, Jewish Day School, or any person associated with any of the previously mentioned organizations, for injury sustained during tryouts, team practice, tournament play, or any activity associated with the participation on any Moxie Juniors team, including travel in private automobiles to any Moxie Juniors team function. I agree to indemnify persons representing Moxie Juniors, Moxie Volleyball and Jewish Day School against costs or judgments associated with any such claim, to the extent permitted by law.  

I have read the waiver of liability and agree to all terms.