Lee College Center for W orkforce and Community Development
Permission/Emergency Registration Form
This form must be completed, including the parent or legal guardian signature for students 17 years or younger.
Registration forms must be submitted to the CWCD O
ffice in person, by mail, or fax.
Student Information (please print all information)
Last Name First Name M.I.
Permanent Address City State
ZIP
Billing Address (if diff
erent than permanent address) City
State
ZIP
Primary Phone Birthdate Entering Grade
Male
Female
PO Box 818, Baytown, Texas 77522-0818
Athletics
SSN# Email Address
Does this child have any disabilities, present injuries, allergies, hemophilia, heart conditions, history of respiratory illness, or any other signifi
cant medical condition?
Yes No If yes, please state: _______________________________________________________________
Parent/Guardian: ________________________________
Home/Cell Phone:
Work Phone:
Employer:
2nd Contact (relationship): __________________________
______________ Home/Cell Phone: ______________
___________________________________ Work Phone: ___________________________________
_____________________________________ Employer: _____________________________________
If I cannot be reached, please contact the person listed below:
Full Name (family, friend): ___________________________ Phone: _______________________
In case of emergency, I hereby authorize treatment and/or care as deemed necessary by the Lee College sta
ff .
Doctor’s Name: __________________________________ Phone: _______________________
Parent or Guardians Signature Date
Model Release: I (check one) grant Lee College permission to use my name/child’s name, photograph, and comments for marketing, advertising, college relations,
and promotional purposes. I understand I will not be paid for any use of my image in any Lee College marketing materials now or in the future.
do do not
Non-Release of Directory Information: I grant Lee College permission to release directory information to the general public without written consent.
Directory items include the student’s name, address, major, activities participated in, dates of attendance, and degrees and awards received.
do do not (check one)
For Office Use Only
RD FERPA
Student I.D. Receipt # Date Initials
Non-Profit Org.
U.S. POSTAGE
PAID
LEE COLLEGE
Baytown, TX
Permit No. 95
Session:
4-on-4 Summer League Week 1 (July 11-12, 6-8 p.m.) Week 2 (July 18-19, 6-8 p.m.) Week 3 (July 25-26, 6-8 p.m.)
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4 ON 4 VOLLEYBALL
LEAGUE DATES
This league will take place on Wednesday/Thursday evenings
in July beginning after the July 4th holiday weekend, from
6-8pm. Please try to arrive at 5:30pm to get your gear on
and start warm up at 5:45pm.
Payment is for all 6 dates.
Wednesday Thursday
Week 1 July 11 July 12
Week 2 July 18 July 19
Week 3 July 25 July 26
CAMP REGISTRATION
Campers should form teams of a minimum of 3 and maximum
of 5 players. Teams will be registered for this camp on a ÿ rst-
come, ÿ rst-served basis, so be sure to register your team ASAP
to ensure your participation. A team representative may turn
in registration forms + payment for the whole team, as long
as each individual has a separate registration form completed,
along with payment per person.
FACILITIES
This camp will be conducted in the Lee College Sports Arena
and Gymnasium. The arena was built in 2003 and has the
capacity to seat 1,500 screaming fans. The arena also boasts a
wellness center, multiple locker rooms, a training room, ÿ lm
room, and two regulation courts. Campers may also be using
the auxiliary gym located next to the Lee College Sports Arena.
EQUIPMENT
Campers should report each day wearing workout clothes,
tennis shoes, and knee pads. No jewelry, watches, or cell
phones are permitted on the courts. Lee College is not
responsible for lost or stolen items.
CAMP INFO
COST
$100 per person
One time payment is for the full 3 weeks/6 dates.
CAMP FEATURES
A max of 4 players allowed on each side of the net at all
times
Maximizes indivudual touches with less players on the
court
Scrimmage focused, highlighting game-like situations
Receive individualized coaching
Growth in all skills such as serving, passing, setting,
hitting, and blocking
Camp t-shirt included
Awards and door prizes
CAMP OBJECTIVES
Develop and improve all skills
Increase overall knowledge through individual and team
coaching
Develop an aggressive and smart o˛ ense
Improve defensively by covering more court
CAMP STORE
The camp store will be open for business each day. Lady Rebel
merchandise will be available for purchase. Cash or check
accepted, checks must be made out to Lee College.
WAYS TO REGISTER
In person: 909 Decker Drive, Baytown, TX
Fax: 281.425.6855 (Visa, MC, Discover, AMEX)
By Mail: Lee College Center for Workforce and
Community Development (CWCD)
P.O. Box 818
Baytown, TX 77522-0818
Online: www.lee.edu/kids
For more information call 281.425.6311
Choose Payment Type:
Cash Check Visa MC Discover AMEX
Card Number
Exp. Date CVV Code Billing Zip Code
Print Cardholder Name
Please make all checks payable to Lee College.
Check #__________ TDL #_____________________
Exp. Date __________________
Registration fees are to be deposited into the Lee College volleyball
fundraising account.
Camp Directed by
PAIGE SORGE
Head Coach at Lee College
Career Highlights
Deer Park High School alum
Former Lady Rebel 2007-2008
NCAA DI scholar-athlete at Houston Baptist University
Played internationally at Durham University in England
Lady Rebel Assistant Coach 2013-2017