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Menu
About CAC
Welcome to CAC
Our History & Mission
School Profile
Administration
Faculty & Staff
Board of Directors
Employment
Contact Us
Admissions
Admissions Home
Visit CAC
Apply to CAC
Tuition & Financial Aid
Request Information
Campuses
Secondary (main) Campus
North Little Rock Elementary
Pleasant Valley Elementary
Academics
Academics Home
Academic Curriculum
Counseling Center
CAC Summer Programs
Student Handbooks
Athletics
Welcome to CAC Athletics
Fall Sports
Winter Sports
Spring Sports
Forms & Downloads
Summer Programs
Mustang Monitor
Athletic Pack Order Form
Fine Arts
Drama
Choir
Band
Visual Arts
Elementary Fine Arts
Student Life
Mustang Missions
Global Studies Program
Daily Announcements
Calendars
Communications
Buy Your Yearbook!
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Volleyball Camp Registration
Volleyball Camp Registration
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Volleyball Camp Registration
Volleyball Camp Registration
Step 1 of 2
50%
Lady Mustang Volleyball Camp Registration
This camp is designed to provide an introduction to the fundamental skills of volleyball. Each camp will be exposed to basic passing, setting, and serving techniques in a relaxed, non-threatening environment.
Student Name
*
First
Last
Student Birthdate
*
Date Format: MM slash DD slash YYYY
Grade Entering
*
Choose One
4th
5th
6th
7th
8th
9th
Tshirt Size
*
Choose One
YS
YM
YL
AS
AM
AL
Parent/Guardian Name
*
First
Last
Address
*
Street Address
Address Line 2
City
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Cell Phone
*
Email Address
*
Emergency Contact Name
*
First
Last
Emergency Contact Relationship to Student
*
Emergency Contact Cell Phone
*
Mustang Athletics Summer Camp Release Form
I give my consent for the following person(s) to pick up my student in my absence:
*
My student has the following allergies:
Comments
Authorization to Consent to Medical Treatment
In the event I cannot be contacted to give consent, I hereby authorize Central Arkansas Christian, Inc. and any employees and agent to provide emergency first aid treatment for my student.
Authorization:
*
Choose One
Yes, I give consent.
No, I do not give consent.
Comments
Authorization of Administration of Medicine
I give my consent for my child to be administered the following non-prescription medication(s) by Central Arkansas Christian, Inc.
Select the medicine for which you give consent.
*
Acetaminophen (Tylenol)
Ibuprofen
None of the Above
Comments
Other Medication
Parents must supply other medicine that may be required for the student. Such medication should be brought to the school in the original container properly labeled with the name of the student, identification of the medication, the dosage and the time to be administered. A Medicine Release Form (found on the Summer Camp Homepage) must be filled out for each medication.
Other Medication
*
Choose One
I will be supplying additional medication for my student.
I will not be supplying additional medication for my student.
Transportation Permission Agreement
I give my permission for the aforementioned student to ride a vehicle (car/bus) to the high school for Mustang Athletics Camps from the Mustang Summer Camp that are sponsored by Central Arkansas Christian Schools, Inc. and supervised by employees. I understand that there is a transportation fee that must be paid. The person named on this form shall indemnify and hold harmless Central Arkansas Christian Schools, Inc. and any employees from any and all claims, liability, loss, damages, or expenses resulting from the trip/activities.
Transportation Permission Agreement
*
I understand my FACTS account will be drafted $10 and give my permission.
My student will not utilize Mustang Summer Camp's transportation.
Mustang Athletics Summer Camps Release
I understand and agree that my electronic signature releases the camp, CAC and any participating party from liability in the event of injury and/or treatment of an injury, illness, or medical problem. My electronic signature also authorizes the treatment of an injury or medical problem by trained medical personnel in the event of an emergency. I also understand that the camp/CAC will not carry insurance for any camper and that any costs incurred in the treatment of any injury or medical problem are the camper’s responsibility.
Mustang Athletics Summer Camps Release
*
I understand the terms and agree. This is my electronic signature.
Payment
$60 | $55 for each additional child
Payment
*
CAC STUDENTS: Draft my FACTS account.
NON CAC STUDENTS: Cash/Check
All checks & cash should be mailed to Gay Passafiume at CAC's Pleasant Valley Elementary campus. (ATTN: Gay Passafiume | 10900 N Rodney Parham Rd, Little Rock AR 72212). You may also drop off your payment at the Secondary Campus front office in an envelope labeled with your student's name and "Mustang Athletic Camp Payment." All checks should be made out to CAC with the camp specified on the subject line.
Please check this box if you are registering a sibling of a student who has already been registered for this camp.
Registering a sibling.
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