Contact Coach Jill

Address
West Broward High School
500 NW 209th Ave.
Pembroke Pines, FL  33029

Pioneer Middle School
5350 SW 90th Ave
Cooper City, FL 33328

Mailing Address:
5722 S Flamingo Rd #418
Cooper City, FL 33330

Phone
954-734-7188

Email
Register for VB Camp
Camper information
First Name:
Last Name:
Email:
Phone:
Address:
City:
State:
Zip:
School:
Camp Session:  
Morning Week 1 $125.00 @ WBHS
Morning Week 2 $125.00 @ PMS
Morning Week 3 $125.00 @ WBHS
Morning Week 4 $125.00 @ PMS
Afternoon Week 1 $125.00@ WBHS
Afternoon Week 2 $125.00 @ PMS
Afternoon Week 3 $125.00 @ WBHS
Afternoon Week 4 $125.00 @ PMS
All Day Week 1 or 3 $225.00 @ WBHS
All Day Week 2 or 4 $225.00 @ PMS
Full Day 2 Weeks $450.00 @ WBHS
Full Day 2 Weeks $450.00 @ PMS
Adult Shirt Size: S M L XL XXL
Parent/
Gardian Name:
Emergency Contact
Mobile:
Alternate:
Insurance Information
Insurance:
Policy:
Insured's Name:
Special Concerns
I, the parent /guardian of the above named child, do hereby give my consent to their participation in all activities of the Bobcat Volleyball Camp. I affirm that my child is covered by primary medical insurance and will continue to be covered through out the duration of their attendance as a camper. I understand that I am responsible for my child's medical bills if injury occurs. I give my consent for medical treatment by the closest hospital, doctor, or medical facility.