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Player Name: ________________________________________________________________________________ Team: ____________________
Primary Contact for Accounting Purposes: __________________________________________________ Cell Phone (____)______________
Primary Email Address (for Electronic Statements from CCJ’s Payment Processing System). PLEASE PRINT LEGIBLY:
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I have read the above details and agree in full with the policies as set forth. I understand that I will receive a Financial Contract and
Agreement once the Commitment Deposit has been paid; and that I am responsible for the season’s full tuition, even if the player is unable
to participate in tournaments and/or training sessions (exception: season-ending injuries before the season’s competition). I further
understand that I will be financially responsible for any fines levied against the club for my (or my athlete’s) misconduct.
My signature below indicates my acknowledgement of the terms and policies for participation in the club. I understand that once a position
is offered and accepted with a Commitment Deposit, it will indicate the commitment to Club Cactus Juniors Volleyball Club. The Arizona
Region and USA Volleyball considers this commitment for the entire season.
Signature of Parent or Legal Guardian _______________________________________________________ Date _____________________
1. The Commitment Deposit is due upon acceptance of the player’s placement to hold their roster position on the team
for the 2021 Season. Player and Parent understand that the Commitment Payment in non-refundable should the player or
the parent change their mind and opt not to participate with Club Cactus Juniors Volleyball Club. Player and Parent
understand and agree that by signing a Contract with Club Cactus Juniors Volleyball Club that they cannot tryout or
participate with any other club team or program through July 1, 2021– or the end of the USA Volleyball Season.
The Tuition includes the following budget items: USAV team registration and Regional Tournament entry fees, player
uniforms and shoes, practice facility rental charges, coaching staff salaries, training equipment, insurance, and
administrative expenses. Player meals and transportation to/from regional and national events are not included.
National (Travel) Team Tuition includes coaching staff and staff travel expenses, entry fees, local transportation and team
lodging at the tournament’s designated hotel. Player transportation (airfare) to/from tournament location is not included.
Parent acknowledges that they will be responsible for making all travel arrangements to/from the tournaments. CCJ
will require all travel plans to be submitted at least 45 days prior to the tournament. In most cases, CCJ can arrange
player and/or team travel at an additional expense that must be paid in full 30 days prior to departure.
2. Tuition may be paid in full (by December 10, 2020) or in monthly payments. If paying per month, the tuition will be spilt
into monthly payments that must be received by the 10th of each month. All CCJ credits will be applied to the last
month’s payment provided account is paid on time. Any outstanding balance at the end of the season will waive all credits.
Payments do not reflect the amount of activity (training and/or competitions) in a given month—some months may have
more activity than others. The payment schedule is offered simply to assist with affordability from month to month.
3. Delinquency is established if scheduled installment payments are not received. Athletes may not be permitted to participate
in any CCJ function (including training and tournaments) until account is brought up to date AND a $25.00 late fee is paid.
Athletes who have outstanding balances are the end of the season will be subject to collections and reported to the
Arizona Region of USA Volleyball and will be ineligible to participate with CCJ and any other club until the debt is satisfied.
All CCJ Credits (Cactus Classic Credit, Commitment Credit, Sibling, etc.) are forfeited if account goes to collections.
4. Athletes are expected to be on time for all training sessions and competitions and in proper uniform as provided by the club.
Missing practices and/or competitions for any reason will not establish any refund nor prorated tuition.
Athletes will receive coaching during all training sessions. Playing time in competitions is strictly at the discretion of the
coaching staff. Playing time will be awarded based on the athlete’s work ethic, attitude, attendance, position, and
performance in practices and tournament. Playing time is not part of the club’s financial contract.
5. Tuition is calculated based on the total expenses for the season, and will not be prorated or reduced should an
athlete miss any training session(s) for any reason; or any tournament(s) for any reason; or if a player quits at any
time for any reason. Players that leave the team or club for any reason will still be responsible for all tuition payments.
Tuition will not be prorated or reduced should a athlete become injured (including concussions) at any time during
the season and miss practices and/or competitions. CCJ recommends purchasing an Athletic Performance Insurance
Policy if you are concerned about injuries or the financial liability due to any unforeseen event.
Should the athlete or parent (or any associated relative or friend) be responsible for any Arizona Region Penalty (Purple Card,
Food/Drink Policy, etc.) that causes CCJ to be charged a fine; the athlete will be financially responsible (player account).
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FOR CCJ USE ONLY | Commitment Received ___ /___ /_____ | Commitment Payment Type: ____________ Payment $ ___________ Date Processed: __________
Name ____________________________________________________________________________________ Birthdate _____ /_____ /______
Address _____________________________________________________________________ City __________________ Zip Code ___________
Phone (____)_________________ Cell Phone (____)_________________ Email Address __________________________________________
Mother Name: ___________________________ Cell Phone (____)______________ Email _________________________________________
Father Name: ___________________________ Cell Phone (____)______________ Email _________________________________________
EMERGENCY CONTACT: If Parent/Guardian named above is not available, please contact:
Name ___________________________________________________ Home Phone (____)____________ Work Phone (____)____________
Relationship to Player ___________________________________ Cell Phone (____)____________ Pager (____)____________
I verify that my child named above has been checked by a licensed physician and is physically able to participate with Club
Cactus Juniors Volleyball Association. I understand that volleyball training and competitions consist of strenuous physical
activity, and have no knowledge of any physical impairment which would be affected by the above named player’s
participation in the volleyball program as outlined. I hereby and promise that I will not hold Club Cactus Juniors Volleyball
Association, nor its coaches, directors, staff and assignees responsible for any loss, damages, or personal injury received as a
result of participation.
I, the undersigned, as the parent or legal guardian of (a minor) hereby authorize such diagnostic, medical and/or surgical
treatment of such minor as may be considered necessary or appropriate under the circumstances for the treatment of any
illness or injury of the minor. The attending physician, appropriate staff, and Club Cactus Juniors, and its directors and
coaching staff shall not be responsible in any way for any consequences from said diagnostic, medical and/or surgical
treatment and are hereby released from any and all claims and causes of action that may arise, grow out of, or be incident to
such diagnosis, treatment, or surgery insofar as the law allows and provided that these services are performed with ordinary
care and to the best of their ability.
______________________________________________________________________________________ _____________________
Signature of Parent/Legal Guardian Date
Medical: Present Health _____________________________________________________________________________________
Past Health __________________________________________________________________________________________________
Past Injuries ________________________________________________________________________________________________
Drug Sensitivities ____________________________________ Other Allergies_________________________________________
Current Medications__________________________________________________________________________________________
Other Medical Information____________________________________________________________________________________
______________________________________________________________________________________________________________
Insurance Information:
Insurance Company__________________________________________________________________________________________
Policy Holder Name: _______________________________________________ Policy Number: ___________________________
Social Security or ID #: _______________________________________________________________________________________
