Online Registration for Roxana Recreation Department Tri-City Volleyball 2024-Fall

Roxana Recreation Department

2024-Fall Tri-City Volleyball

For BOYS OR GIRLS grades 3-6

Co-Ed Teams are divided by league and grades 3/4 and 5/6
The volleyball program is designed to develop individual skills and basic fundamentals of the game in a team setting
Games being in November
Games will be played at Roxana Community Gym, East Alton Keasler Complex, and Wood River Recreation Center
Games will be played on week nights and Saturday mornings
No team registrations
Games begin in November
12 game schedule
League Shirts Included in registration fee

Fee: $50 (A $10 late fee will be added after the deadline)
Registration deadline is Friday October 4, 2024

Division/Option (required)

Division/Option is required

Player First Name (required)

Player First Name is required

Player Last Name (required)

Player Last Name is required

Player Gender (required)

Player Gender is required

Player DOB (required)

Player DOB is required

Player Height (required)

Player Height is required

Player Birth Month (required)

Player Birth Month is required

Player Birth Day (required)

Player Birth Day is required

Player Birth Year (required)

Player Birth Year is required

Player Age (required)

Player Age is required

Player Shirt Size (required)

Player Shirt Size is required

Player School (required)

Player School is required

Player Grade (required)

Player Grade is required

Played Last Year? (required)

Played Last Year? is required

Team Last Year

Team Last Year is required

Parent First Name (required)

Parent First Name is required

Parent Last Name (required)

Parent Last Name is required

Parent Phone (required)

Parent Phone is required

Parent Email (required)

Parent Email is required

Parent Street (required)

Parent Street is required

Parent City (required)

Parent City is required

Parent State (required)

Parent State is required

Parent Zip (required)

Parent Zip is required

Medical Conditions

Medical Conditions is required

Emergency Contact Name (required)

Emergency Contact Name is required

Emergency Contact Relation (required)

Emergency Contact Relation is required

Emergency Contact Phone (required)

Emergency Contact Phone is required

Volunteer? (required)

Volunteer? is required

Volunteer Name

Volunteer Name is required

Volunteer Phone

Volunteer Phone is required

Terms and Conditions / Waivers
By submitting this registration you agree to the following.

Parents Code of Ethics - I, the named or legal guardian of this child, do agree and abide by the Parents Code of Ethics

Waiver Parents Code of Ethics is required

May Participate - I do hereby consent and agree that the above named minor may participate in the Tri-City, Roxana Recreation, Wood River Parks and Recreation, and/or East Alton Parks and Recreation program.

Waiver May Participate is required

No Fault - I acknowledge that there are certain risks of physical injury associated with my child’s participation in the above name program which may occur through no fault of any volunteer, participant, employee, or officer of Tri-City, Roxana Recreation, Wood River Parks and Recreation, and/or East Alton Parks and Recreation and/or any other sponsors or party.

Waiver No Fault is required

Terms and Conditions / WaiversBy submitting this registration you agree to the following.

Terms and Conditions / Waivers
By submitting this registration you agree to the following.