LVC 14 BLACK - Team Roster
Tournament Site: _______________________________________Tournament Date: ___________
Club: LOCKPORT VOLLEYBALL CLUB Team Rep: Thomas Schneider
Team: LVC 14 BLACK6313 Green Valley Ln
Team Code: MJ4LOCKP1WE Lockport, NY  14094
Region Division: Boys' 14's716-310-2781
Event Division Entered: __________________________________Email: tschneid22@aol.com
#PosNameUSAV # Coach
Status
Coach
Cert.
RefScoreSSBadgesMbr
Stat
4  Player Smith, Andrew WE3008219MJ19 Y C
6  Player Saunders, EVAN WE2870415MJ19 Y C
7  Player Krchniak, Kaidan WE2892122MJ19 C
9  Player Ouellette Jr., Kenneth WE3000440MJ19 C
14  Player Clouse, Andrew WE2887182MJ19 Y C
15  Player Glynn, Solomon WE3119397MJ19 C
18  Player Jelen, Matthew WE2892008MJ19 C
22  Player Zawada, Jonathan WE2997718MJ19 Y C
23  Player Anderson, Peyton WE3038677MJ19 C
24  Player Wynne, Joseph WE3131942MJ19 C
76  Player Klumpp, Robert WE3163063MJ19 Y C
88  Player Beiter, Andrew WE2890000MJ19 Y C
 Head Coach Schneider, Mary WE2367696FR19 Eligible IMPACT Y Y Y C
 Asst. Coach Earl, Katherine WE2035497FR19 Eligible IMPACT Y Y C
 Asst. Coach Travale, Maria WE3129496FR19 Eligible IMPACT Y Y C
 Asst. Coach Schneider, Thomas WE1312903MR19 Eligible IMPACT Y Y Y C
USA Volleyball Badge Key: 1 = R1, 2 = R2, S = Scorer, L = Libero Tracker, J = Line Judge
ROSTER & USAV Medical/Emergency Release Form Verification
Coaches of the teams in this event are required to carry with them at all times completed USAV Medical/Emergency release forms.
The person signing this form verifies that:
  1. The above roster is correct and contains all players who will be participating in the event.All players meet age requirements.
  2. They will have in their immediate possession at all times during this competition a completedcopy of the USAV Medical/Emergency Release Form for each player listed on the official roster.
  3. The team understands it is subject to any and all penalties if this roster does not match theparticipants attending the event, regardless of who signs this verification.
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Print NameSignature
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Phone Number (If different from above)Date
 

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