2026 September & October Academies - Dynamic Impact Volleyball Club

Athlete’s Name *
Date of Birth *
Current School Grade
Address *
City *
State *
ZIP *
Academy Choice (A Separate Form Must be Entered For Each Academy Attending) Spots are given on a first sign-up basis. Academies to be held at Schaumburg Christian School at 200 N Roselle Rd., Schaumburg.

Name *
Phone *
Email *
Instructions In consideration of my child’s participation, I hereby release the Dynamic Impact Volleyball Club staff, officers, employees and Dynamic Impact Co. for any and all liability arising out of any injury or illness my child incurs while participating in camp activities. I understand the rigorous athletic activity in which she will be involved. I understand that participation is voluntary and I choose freely to have my child participate. By applying, I understand that DIVC may take photographs and/or videos of camp participants and activities. I agree that DIVC shall be the owner of and may use such photographs and videos relating to the promotion of Dynamic Impact Volleyball Club. No refunds will be given for missed dates.
Parent/Guardian Signature *
Date *