Adrenaline USA Volley Ball

evaluation form


This form is used for individual athlete evaluation and is required in advance prior to participation. Please fill out completely and to best of your ability as we use it to be serve you. 2023-2024 Teams Evaluations dates are in AUG. SEPT. AND OCT. All other days are available upon request and by appointment through the course of the year. This applies to all teams participating in the 2023-2024 season. Basic Evaluations Information: Registration is open to the public but limited Locations: Fort Myers Skatium 2250 Broadway Ave Fort Myers 33901 Esporta Fitness 8951 Bonita Beach Rd.Bonita Springs Fl 34135 Sept & Oct Evaluation Sessions (in Naples) TBA. Required forms for participation need to emailed to the club in advance: 1. Copy of Birth Certificate or Passport 2. AAU Membership created at select Youth Membership 3. Evaluation Form completed and submitted in advance of on court participation 4. A 1 time $35 payment made via CC by request, Zelle: [email protected] Venmo: @Adrenalineusa-volleyball Cash app: $AUSA-Volleyball, cash, or check (from current members only). Please let us know if you have any questions. Contact directly. Evaluation Session tips prior to evaluation: Arrive at least 15 minutes prior to check in and start time. Bring all training needs and have all necessary gear on prior to start time. Place personal gear in designated area off of the playing court space. Be ready to join in court side and check in with on court staff giving you name and age if you are late to check in. Post evaluation you will receive a communication via email text or phone call within 24 hour of participation indicating which level of team or program your are invited to participate in. Any rescheduling needs due to a missed evaluation needs to be coordinated via email. Be sure to complete application via parent portal and upload yourself into the club app immediately if accepted. This is an inclusive organization and we work to find a place or program for everyone, but we are a private organization and are not required to take everyone. Current members are required to attend 1 tryout but are permitted to attend as many as they prefer. New members are required to attend 1 tryout and are highly encouraged to attend more than one.

First and Last Name
No experience required for beginner or intermediate sessions. Being descriptive helps staff place participant in appropriate groups in sessions. Ie.: 3 camps 1 clinic, 2 seasons of travel
Parent & player email address. Parent Guardian required.
Pick up drop off information and special permissions information. Special needs ie. diabetic may need more frequent snacks, grandma picking up Tuesday.
The following is needed for all evaluations: 1. A youth AAU membership from You can use club code W34FDY to affiliate in the account affiliation box or leave blank and we will import you. 2. A copy or birth certificate or passport emailed un advance to: [email protected] 3. One time Evaluation Fee of $35.00 sent via zelle: [email protected] Cash app $AUSA Volleyball Venmo @AdrenalineUsa- Volleyball Cash & CC (available upon request) Check payment for current members only. Evaluations are conducted year round and one is required prior to any team participation. Indoor Locations are: Fort Myers Skatium 2250 Broadway Ave Fort Myers Fl 33901. Esporta Fitness 8951 Bonita Beach Rd, Bonita Springs, Fl Southside Christian Church 7800 College Parkway, Fort Myers, FL, 33907. NAPLES location TBA *Bonita location evaluates players for Naples based teams as well.
New participants or non-members are permitted to use any method of payment available with exception of check.
Desired preference level of team or program
Please choose which best describes the level of team or program you are evaluating form. Please check all that apply.
The novel coronavirus, COVID-19, has been declared a pandemic by the World Health Organization. COVID-19 is extremely contagious and is believed to spread mainly from person-to-person contact, including individuals without disease symptoms. As a result, federal, state, and local governments and federal and state health agencies recommend social distancing and have, in many locations, prohibited or limited the congregation of groups of people. The health and well-being of our staff and athletes remains our top priority. In order to minimize the risk of COVID-19 entering our environment and spreading amongst our community, we will only allow staff assigned to work and athletes scheduled to participate to be in our gym. Parents wishing to remain on site can use outdoor common areas or the parking lot to wait for their athlete(s). Athletes waiting to attend a session will need to wait outside while maintaining social distance from others. Furthermore, all participants in sponsored activities at must agree to and abide by the following: MAINTAIN REQUIRED SOCIAL DISTANCING PROCEDURES AND SPACING WEAR MASKS WHEN ASKED REFRAIN FROM UNNECESSARY PHYSICAL CONTACT NOT ATTEND ANY ACTIVITITES IF DISPLAYING ANY SYMPTOMS OR A FEVER OVER 100.1 F. BE CLEARED BY A PHYSICIAN PRIOR TO RETURN IN THE EVENT OF ILLNESS AND COMPLETED ANY NECESSARY TESTING PROVIDING COPIES OF TESTING CLEARANCE TO THE CLUB IN WRITING NOTIFY THE CLUB IN WRITING OF ANY NECESSARY MEDICAL RELATED NEEDS PARTICIPATE IN ROUTINE HAND WASHING AND ANY ADDITIONAL PERSONAL SANITIZING STEPS BE WILLING TO PARTICIPATE IN REQUIRED FEVER TESTING PRIOR TO TRAINING NOT SHARE ITEMS SUCH AS WATER BOTTLES FOLLOW ANY GOVERNMENT REQUIRED APPLICABLE GUIDELINES (hereafter referred to as the “Club”) has put in place numerous preventative measures and enhanced cleaning protocols to reduce the likelihood of spreading COVID-19 in Club’s gym environment; however, the Club cannot guarantee that you or your child(ren) will not become infected with COVID-19. Further, attending sponsored activities at the Club could increase your risk and your child(ren)’s risk of contracting COVID-19. By signing this agreement, I acknowledge the contagious nature of COVID-19 and voluntarily agree to the participation terms described above and assume the risk that my child(ren) and I may be exposed to or infected by COVID-19 by attending the Club and that such exposure or infection may result in personal injury, illness, permanent disability, and death. I understand that the risk of becoming exposed to or infected by COVID-19 at the Club may result from the actions, omissions, or negligence of myself and others, including, but not limited to, Club employees, volunteers, and program participants and their families. I voluntarily agree to assume all of the foregoing risks and accept sole responsibility for any injury to my child(ren) or myself (including, but not limited to, personal injury, disability, and death), illness, damage, loss, claim, liability, or expense, of any kind, that I or my child(ren) may experience or incur in connection with my child(ren)’s attendance at the Club or participation in Club programming (“Claims”). On my behalf, and on behalf of my children, I hereby release, covenant not to sue, discharge, and hold harmless the Club, its employees, agents, and representatives, of and from the Claims, including all liabilities, claims, actions, damages, costs or expenses of any kind arising out of or relating thereto. I understand and agree that this release includes any Claims based on the actions, omissions, or negligence of the Club, its employees, agents, and representatives, whether a COVID-19 infection occurs before, during, or after participation in any Club activities.
Please review and complete the sections below and sign in the space provided to indicate your agreement with all statements made in each section. By entering a guardian/parent name above you acknowledge are agreeing to liability release for Adrenaline USA Volleyball as follows. AUTHORIZATION AND RELEASE OF LIABILITY: I, the parent or guardian of the above-named child, authorize the participation of my child in ADREANLINE USA VOLLEYBALL I understand that this Program is a nonprofit sports ministry program for youth and that my child’s participation is voluntary and not essential to completion of requirements of any program, school, or government agency. I understand that the Program is conducted by ADRENALINE USA VOLLEYBALL and its volunteers and staff, including parents of other participating children. I also understand that ADRENALINE USA VOLLEYBALL is solely responsible for all aspects of the Program including selection and supervision of all persons conducting the Program. I further understand and agree that my child’s participation in athletic and other activities of the Program necessarily involves the risk of injury and even death from various causes, including but not limited to accidents, falls, strenuous and prolonged physical activity, dehydration, illness, collision or dispute with other participants, weather related injuries, playing area and equipment defects, and negligence of coaches and referees. On behalf of my child, me, and my family, I assume these risks. In consideration of the privilege of my child’s participation in the ADRENALINE USA VOLLEYBALL Program, and on behalf of my child and me as parent/guardian, I hereby release, discharge, hold harmless and indemnify, and covenant not to sue, ADRENALINE USA and all of the directors, officers, employees, volunteers, insurers, agents and representatives, and all other persons associated with ADRENALINE USA VOLLEYBALL (including without limitation any other participating sponsors, parents, vendors, coaches and other game and event workers, officials, drivers, and organizations) as to any and all claims of my child, me and other family members for personal injuries suffered by my child, property damage, medical expenses, and economic loss arising directly or indirectly out of my child’s participation in ADRENALINE USA VOLLEYBALL, and any first aid, medical care, or treatment provided to my child in the event my child is injured or becomes ill while participating in ADRENALINE USA VOLLEYBALL activities, and excepting claims that may not be released under applicable law. This Release of Liability shall be as broadly construed as allowed by law to include all claims and rights that the child, that I as parent/guardian, and that other family members may have. I am a legally responsible parent or guardian of my child. If any provision of the Release of Liability is deemed invalid, the remaining provisions shall remain in full force and effect. This Release of Liability shall be binding on me, my family, heirs, next of kin, legal representative, beneficiaries, successors, and assigns. I give permission for free use of child’s name and picture in broadcasts, telecasts, or written accounts for any participation in an ADRENALINE USA VOLLEYBALL spsored event. I affirm that this form was signed by only one parent/guardian because (1) I am the sole parent/guardian responsible for the care and custody of the child due to death or incapacity of the other parent/guardian or court order, or (2) I have made a good faith effort to obtain the signature from the other parent/guardian but have not been able to do so due to causes beyond my control, and I am not aware of any reason that the other parent/guardian objects to the child’s participation in the Program. MEDICAL CONDITIONS: I understand that participation in the Program may involve strenuous and prolonged physical activity. I agree that my child is healthy and able to participate in the Program activities. I understand that ADRENALINE USA VOLLEYBALL or its representatives may request health information concerning my child and/or ask my child to undergo a medical exam. If ADRENALINE USA VOLLEYBALL determines that my child does have a physical or mental condition that may affect his/her ability to safely and appropriately participate in Program activities, they may determine that my child cannot be permitted to participate. I understand and agree that, while the ADRENALINE USA VOLLEYBALL desires that all children will be able to participate, such decisions may have to be made out of concern or the best interest of my child and other participants. CONSENT TO MEDICAL TREATMENT: In the event my child is injured or becomes ill in Program activities, and if I, the parent or guardian of the above-named child, am not present to make medical decisions, I hereby authorize ADRENALINE USA VOLLEYBALL, its staff, volunteers, including volunteer parent participants, coaches, assistant coaches, and referees, supervisors and drivers, to arrange for and consent on my behalf to emergency medical and dental care and treatment, including tests and radiological exams, and surgery, and hospital care and treatment, and to consent to medication for pain and other conditions as prescribed by medical personnel attending my child. I am responsible for payment of any medical charges or expenses not covered by my insurance or the insurance applicable to my child (if any). My signature below indicates that all information provided in this form is true and accurate, and that I fully agree to all statements made on the form, including but not limited to the Authorization and Release of Liability, Medical Conditions, and Consent to Medical Treatment. Each responsible parent/guardian should sign.
Desired Practice Location
Please check all that apply
In summer time we offer international travel team in July with Tours in Europe or South America. Please indicate interest level.
Please indicate if you are an international player wanting to participate in the US or transferring by way of membership.
Please let us know any individual athlete or player goals you have this season. As detailed as possible is encouraged and accepted even if general.
Please let us know any additional information you feel is necessary to know in advance of evaluation and acceptance to programs and membership.