____________________________ Years Varsity____________________________ Years Club____________________________ Coach Accommendation Letter

Name___________________SS#___________Age___Ht.___Grade___Address: City____________________State_____Zip___________High School______________High School Coach_______________Phone(___)_______Roommate Request(1 only)________________T-shirt size_________Full time camper ($320) ____Commuter ($280)Graduation Year _______ Playing Position_________________

I hereby authorize the directors of this camp to act according to theirbest judgement in the event of any medical emergency.

Parent’s or Guardian’s Signature______________________________

Return this form plus a $100 non-refundable deposit for elite camp to:

Kentucky Volleyball Camps
Memorial Coliseum, University of Kentucky
Lexington, Kentucky 40506-0019