Forms

Surge Forms

This page is to allow for easy access to all of our online fill-able forms. Click the name of the form to open the form in a popup to be viewed and/or completed.

Surge In Season Parent Forms:

Fall Junior League

Player Name(required)

Parent Name(required)

Address(required)

City(required)

Zip Code(required)

Email address(required)

Phone(required)

T-Shirt Size(required)

School(required)

Grade(required)

Assumption of Risk, Waiver, and Release from Liability

Risk Factors- I understand and acknowledge that the use of equipment, fields, & facilities provided by the Program and participation in the Program involves risks including, but not limited to the following: risk of property damage, bodily injury, including, but not limited to permanent disability, paralysis, and possibly death. These risks may result from a variety of circumstances including, but not limited to, the use or misuse of the equipment or facilities, from the activity itself, health concerns, from the acts of myself or others, including Program and its agents or from the unavailability of emergency medical care.

Assumption of Risk- I am participating in the Program at my own free will. I understand that my decision to participate in the Program is entirely voluntary. I assume full responsibility for all risks that may arise out of or result from my participation in the Program. Excepted from this section are any injuries caused by the gross negligence or willful or wanton misconduct of any officials, officers, employees, agents, or volunteers of Program.

Release, Indemnify, and Defend- I hereby release, waive, discharge, and hold harmless Ron Humer, Surge Volleyball, Maidencreek Township, & all of their affiliates, predecessors, successors, trustees, officers, directors, faculty, employees, agents & representatives, past or present (hereinafter jointly referred to as “the Released Parties") from any and all claims, suits, liabilities, judgments, costs and expenses ("Claims") for any property damage, property loss or theft, personal injury or illness, death or other loss arising from or relating to my participation in the Program.
I also agree to defend, indemnify and hold harmless the Released Parties from & against any Claims arising from or related to my own acts or omissions in connection with my participation in the Program.

I have read and fully understand this Assumption of Risk, Waiver, and Release from Liability and understand that it relates to surrendering and releasing valuable legal rights. I do so freely and voluntarily.

I agree(required)

By entering my full name and submitting this form, I acknowledge that I have read and fully understand this Assumption of Risk, Waiver, and Release from Liability and understand that it relates to surrendering and releasing valuable legal rights. I do so freely and voluntarily.

AGREEMENT(required)

I agree

I understand that I must pay the $160 on or before the first practice in order for my child to participate. All fees are non-refundable. Payment can be made by check made payable to "Surge Volleyball" or via paypal at https://www.paypal.me/SurgeTryout/165 (3.5% fee for online payments added).

Comments:

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First Name(required)

Last Name(required)

Phone Number

Email Address(required)

Questions/Comments(required)

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Surge Saturday Clinics

Player Name (required)

First and Last Name

Email address(required)

Team(required)

Select Team or scroll to bottom and select "Non Surge Player" if you are not on a Surge Team.

Surge Gym Clinics

Surge Gym GIRLS 12U-18U Clinics

7/27/2021 cancelled

Surge Gym BOYS 15U-18U Open Play

No camps scheduled

Lancaster Clinics

Lancaster Mennonite HS GIRLS 12U-18U Clinics

None Scheduled

COVID Questionnaire(required)

By signing up for a Surge clinic(s), I certify the following: - In the last 14 days, my player does not have difficulty breathing, chest pain, loss of smell, or traveled outside of the state. - In the last 14 days, my player has NOT come in contact with anyone with COVID, is not waiting for a test result for COVID, does not have any symptoms of COVID.

I understand: (required)

- If my player had COVID, it has been more than 5 days symptom free and more than 10 days since symptoms started.

Participation Consent:(required)

Participation Consent: Please be assured that we are taking all the necessary steps set forth by the CDC and state for sterilization and sanitation. However, it is possible to contract COVID-19 (or any other communicable disease) in any public space. Our gym will provide for socially distant rules and steps to enhance our level of safety. However, due to the nature of playing the sport of volleyball, a 6 foot distance is not always possible between the players. Reopening social aspects comes with some risks that we all must weigh, but we also want you to feel confident that our club is taking every step to keep our patients and staff safe during this difficult time. Clicking "yes" below indicates that the risks involved are accepted, and that consent is given for participation and instruction to be provided by the coaches, staff and officers of Surge Volleyball Club

Comments:

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Surge Summer Camp

**Surge 2020****Surge 2020****Surge 2020**

**SURGE 2020****SURGE 2020****SURGE 2020** So much growth, so much love for the game, We are Surge and We are "Coaching for the Kids!"

Select Spring Clinic to Attend:

Girls & Boys Skills I Jun 8-10 9:00am-11:00am

Girls Skills II Jun 8-10 11:30am-1:30pm

Girls Skills III Jun 8-10 2:00pm-4:00pm

Skill I, II, III: $150 Each Registration closes on June 1st, 2021. No onsite registration/signups. Camp fee is non-refundable. Please make checks payable to “Surge Volleyball”. Online registration only! Camp fee can be paid via Paypal (with admin fee added), venmo @Surgevbc or by mailing check to: Surge Volleyball, PO Box 343, Blandon, PA 19510

Select Summer Camp to attend:

Girls Skills I Aug 16-18 9:00am-12:00pm

Girls Skills II Aug 9-12 5:00pm-8:00pm

Girls Skills III Aug 9-12 9:00am-4:00pm

Surge Summer Camp Signup Dates and Fees Registration not complete until payment’s received. Click on Amounts Below for Paypal link – fee added for online payment or submit payment via venmo @Surgevbc (no fee) Early Sign up Before 4/30/2021 Skill I $150 Skill II $175 Skill III $225 Registration 5/1/2021-6/30/2021 Skill I $170 Skill II $195 Skill III $245 Late Registration 7/1/2021-7/15/2021 Skill I $220 Skill II $270 Skill III $295

Select Boys Camp to attend:

Boys Skills Camp 12:00-3:00 pm 15yo-18yo

Surge Summer Camp Signup Dates and Fees Registration not complete until payment’s received. Paypal link – fee added for online payment or submit payment via Venmo @Surgevbc (no fee) Boys Skills I 9:00-11:00 am 11yo-14yo - $150 Boys Skills II 12:00-3:00 pm 15yo-18yo - $175

Player Name(required)

Player Address(required)

City(required)

Zip(required)

Email address(required)

Phone

School(required)

Grade(required)

Size(required)

Payment Option(required)

Mail Check

PayPal

Venmo @SurgeVBC

Mail check to Surge Volleyball, PO Box 343, Blandon, PA 19510 OR Submit payment via PayPal on the next page. Registration closes based on dates above. No onsite registration/signups. Camp fee is non-refundable. Please make checks payable to “Surge Volleyball”.

Waiver(required)

I agree to these terms.

I hereby release Surge Volleyball and the Fleetwood Borough, their agents, employees, or instructors on behalf of my child, from any, and all liability for any accident or injury that may be sustained while participating in the any of the Surge Volleyball summer clinics listed above. I hereby release liability against any employee or persons required to administer first aid or to obtain medical care from any licensed physician, hospital or medical clinic for the participant named herein when time is of the essence and/or when the parent/guardian cannot be reached. I understand the camp fee is non-refundable for any reason. I do declare the stated is true and correct and willingly agree to these terms.

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Surge Coaches Resources:

Tournament Results – COACHES ONLY!

Surge Coach Player Request

Form submitted!

SURGE PLAYER REQUEST FORM Submit player requests for players who will be missing for a tournament. Please submit as early as possible.

Please enter details on the player you need along with the date of your tournament.

Coach name

Email address(required)

Select team(required)

Date Player Needed(required)

Day Month Year

Number of Players Needed(required)

Positions Needed(required)

Outside

Middle

Right Side

Setter

Defensive Player

Libero

Utility

Any

Select all positions needed. if more than one player requested.

Coach Comment:

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Surge Forms

Surge In Season Parent Forms:

Surge Summer Camp

Surge Coaches Resources:

Team Package

Please check your order for accuracy!

Surge Forms

Surge In Season Parent Forms:

Surge Summer Camp

Surge Coaches Resources:

Team Package Order Form

Team Package

Please check your order for accuracy!