Try-Out #: __________ Team/Age:_____________ Paid: ______

NAME:__________________________AGE:  ____________

Address: _______________________ City/Zip: __________

CURRENT GRADE AS OF 2006-2007:  _______________

 (ie., 4^th, 5^th, 6^th, 7^th, 8^th, etc.)

School: _______________________________________

Previous Club(s) & Team Level:  ____________________

DOB _______/_______/_______    SS#: ____________

                                     ** (SS# need at least last 4 digits)

Height ____Weight:____   Position Trying Out For: ___________

Mother’s Name: ______________ H/Phone:  _____________

W/Phone: __________________  C/Phone:  _____________

Father’s Name: _____________   H/Phone:  _______________

W/Phone: _________________  C/Phone:__________________

Emergency Contact: ______________Relationship:________________

H/Phone: ________________  C/Phone:______________

Physical Limitations/Chronic Injuries/Illnesses: _______________________________________________

Volleyball Exp:___________________________________

V-ball Goals: ____________________________________

(All offers will be made via e-mail or phone, please be sure to give correct and accurate e-mail  & phone information.)

Phone # to make offer: ____________________________________

E-Mail addy to make offer: ________________________________