KC Premiere Volleyball
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4th Grade Online Registration
First, Read This Information! - There is considerable amount of information on this page due to our having to add a COVID-19 Precaution Waiver per which an electronic signature is needed stating that you acknowledge and have read the waiver.  We recommend that you fill out this form on a computer BUT, if you are doing so with your cell phone, we highly recommend that you FIRST scroll all the way to the bottom to make sure you can access the form Submit button.
Our Online Registration and Payment is a 2 step process:
  1. Fill out the player information form provided below.

  2. Upon clicking the Submit button, you will be taken to our online payment system provided by Groundwork.com Once at the secure Groundwork site follow instruction and provide information as requested. ​​*NOTE that once at Groundwork.com, you will need access to your e-mail to initiate the payment process.  

If you would rather have a "hard copy" form, please
  • E-mail Patty
Spring Sign-up is OPEN
  • Signup Deadline: March 15, 2021
  • Practice starts: week of March 21st
  • Games: April 9 thru May 21st, 2021
Fee: 
  • $110.00 per child​
NOTE: If using a "cell phone" to fill out this form... Before you begin, scroll to the bottom to make sure you can see the Submit button, if not, turn your phone sideways. You can also use your finger to move the content Left to Right. IF you still cannot see the Submit button, please use a computer to fill out the form.

NOTE:  If you are using a computer at your "work place" to fill out the form, note that some office computer security systems and firewalls might not allow you to submit the form. If you try and cannot, then you must use a computer outside of your work place.

You Must Read The Following and Agree, Before Signing Up

COVID-19 Waiver
In consideration of being allowed to participate in any way in the  Club North and KC Premiere Volleyball,  LLC., athletics/sports program whether involving team or individual sports and related events and activities, the undersigned acknowledges, appreciates, and agrees that:
  1. The risk of injury and/or illness from the activities involved in the program is significant, including the potential for permanent paralysis and death, and while particular rules, equipment, and personal discipline may reduce the risk, the risk of serious injury does exist;
  2. The risk to have direct or indirect contact with individuals who have been exposed to and/or diagnosed with one or more communicable diseases, including but not limited to COVID-19 or other medical conditions, diseases, or maladies, and/or any mutation or variation thereof does exist and it is impossible to eliminate the risk that I could become infected through contact with or close proximity to an individual with a communicable disease;
  3. I KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS, both known and unknown, EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASES or others, and assume full responsibility for my participation; and,
  4. I willingly agree to comply with the stated and customary terms and conditions for participation. If, however, I observe any unusual, significant hazard during my presence or participation, I will remove myself from participation and bring such hazard to the attention of the nearest official immediately; and,
  5. I, for myself and on behalf of my heirs, assigns, personal representatives and next of kin, HEREBY RELEASE AND HOLD HARMLESS CLUB NORTH & KC PREMIERE VOLLEYBALL,LLC, its officers, officials, agents and/or employees, other participants, sponsoring agencies, directors, sponsors, advertisers, and, if applicable, owners and lessors of the premises, including Parkville Athletic Club, LLC; PRTSC, LLC; Don & Faye Alexander and M&M Beans, LLC., used to conduct the event (collectively, the "Releases"), WITH RESPECT TO ANY AND ALL INJURY, ILLNESS, DISABILITY, DEATH, or loss or damage to person or property, WHETHER ARISING FROM THE NEGLIGENCE OF THE RELEASES OR OTHERWISE.
I HAVE READ THIS RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND SIGN IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT.

FOR PARENT/GUARDIAN OF PARTICIPANT OF MINORITY AGE: This is to certify that I, as parent/legal guardian with legal responsibility for this participant, do consent and agree to his/her release as provided above of all the Releases, and, for myself, my heirs, assigns and next of kin, I release and agree to indemnify the Releases from any and all liabilities incident to my minor child's involvement or participation in these programs as provided above, EVEN IF ARISING FROM THEIR NEGLIGENCE.

By signing up for this training, camp or league, parent or legal guardian agrees to the above statements. Parent or legal guardian of each youth player must type their name in the online form space following. I agree that typing in my name acts as my legal signature.... see below:
► Report a Problem With This Form
<a href="https://secure.blueoctane.net/forms/FZ4DL20H4B4T">Click Here To Load This Formexperts.com Form</a>
Patty Reynolds, Director
  • 816-529-0282
  • E-mail Patty
KC Premiere Volleyball
5108/5110 NW Waukomis 
Riverside  MO 64151
Are You Interested In More 
"Competitive Volleyball?" ...visit our
​Club North website:
 www.clubnorthvb.com 
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  • Home
    • Interest Inquiry Form
  • League Registration
    • League Information
    • 2nd3rd Grd Fun Volleyball
    • 4th Grade Registration
    • 5th6th Grade Registration
    • 7th8th9th Grade Registration
  • Practice Schedules
  • Game Schedules
  • Rules
  • Camp Info
    • All Skills Camps & Trainings