SMACK OUT SMACK DODGEBALL TOURNAMENT

SMACK OUT SMACK

DODGEBALL REGISTRATION
PACKET
Thursday, April 6th 6pm to 8:30pm
Virginia Beach Middle School Gymnasium
Requirements for participation

5 students per team

$30 per team ($6 per person)
Teams must submit their $30 team fee
to Mr. Pratt in Room 108 or Room 216
during 1B by Wednesday April 5th
Each team must submit a team
registration form
Each player must turn in a signed
medical waiver

Questions?
Contact: Will McKeever (757-284-6447)
 SMACK OUT SMACK DODGEBALL TOURNAMENT

Dodgeball Registration Form

WHEN? Thursday, April 6th
WHERE? VB Middle Gym
TIME? 6 pm to 8:30 pm

Registration Fee: $6 per person ($30 PER

TEAM)

Team Team Captain

Name (Player 1)

Player 1 Grade

Player 2 Grade

Player 3 Grade

Player 4 Grade

Player 5 Grade

Bring these completed forms with your entry

fee to Room 108 or Room 216 during 1B

YOU MAY NOT PLAY WITHOUT THE COMPLETION

OF THIS FORM AND THE MEDICAL WAIVER

Questions?
 SMACK OUT SMACK DODGEBALL TOURNAMENT

Contact Will McKeever (757-284-6447)

Medical Waiver
Please turn into Room 108 or Room 216 during 1B
FAILURE TO TURN IN A MEDICAL WAIVER WILL RESULT IN
DISQUALIFICATION

I, , DO HEREBY FOR MYSELF,

MY HEIRS, AND ASSIGNS, WAIVE AND RELEASE ANY AND ALL CLAIMS
TO DAMAGE AGAINST FIRST COLONIAL HIGH SCHOOL, VIRGINIA BEACH
MIDDLE SCHOOL, THE NATIONAL HONOR SOCIETY AND ITS AGENTS OR
AUTHORIZED REPRESENTATIVES, AS A RESULT OF ANY AND ALL
INJURIES INCURRED BY ME FROM OR WHILE PARTICIPATING IN THE
ABOVE MENTIONED PROGRAM.

SIGNATURE OF PARENT DATE

SIGNATURE OF PARTICIPANT DATE

N.A.D.A CODE OF CONDUCT

1. Understand, appreciate, and abide by the rules of the game.

2. Respect the integrity and judgment of game officials.
3. Respect your opponent and congratulate them in a
courteous manner.
4. Be responsible for your actions and maintain self-control.
5. Do not taunt your opponents and refrain from using foul or
abusive language and gestures.
 SMACK OUT SMACK DODGEBALL TOURNAMENT

SIGNATURE OF PLAYER DATE