MAQ

Elite Volleyball Combine Registration

    (THE ABOVE CHECKBOXES MUST BE CHECKED AND WILL BE VERIFIED.) I hereby state that Maq and Dschierbaum LLC in co-operation with 5310 Hauserman LLC is not responsible for any pre-existing injury or recurrence of any undisclosed pre-existing injury or illness of the above participant. Maq and Dschierbaum LLC will only assume responsibility for injuries incurred while the above participant is participating in activities under supervision during enrolled period, up to the limits of the facility and organizations insurance coverage. I acknowledge that there are natural hazards associated with training and working out as well as related activities indoor and outdoor settings. I hereby affirm that I/and or my child is in good health and physically capable of performing the required activities of this training regime. In consideration of Maq and DschierbaumLLC accepting me/or my child and to the extent permitted and provided and provided by state law, I hereby release and forever discharge Maq/Dschierbaum LLC, its unit, agents and employees from all claim of liability for any damages injuries which may be sustained while I am/or my child is at training. The law requires that personal permission be obtained for medical treatment of minors. The following content form should be signed by the parent so that such procedures may be promptly carried out, and so that no unnecessary delays will occur with treatment. However, no operation will be performed, except emergency without parent’s being contacted and fully informed. I give permission of such diagnostic, therapeutic, and operative procedures as deemed necessary.

After clicking submit, complete registration with payment via Check, Cash, PayPal or Credit Card.

Please make checks out to: Dschierbaum LLC
Mail to: PO Box 29183, Parma, OH 44129

Pay Online: