LVC 14 BLACK - Team Roster
Tournament Site: _______________________________________	Tournament Date: ___________
Club: LOCKPORT VOLLEYBALL CLUB	Team Rep: Thomas Schneider
Team: LVC 14 BLACK	6313 Green Valley Ln
Team Code: MJ4LOCKP1WE	Lockport, NY  14094
Region Division: Boys' 14's	716-310-2781
Event Division Entered: __________________________________	Email: tschneid22@aol.com

#	Pos	Name	USAV #	Coach Status	Coach Cert.	Ref	Score	SS	Badges	Mbr Stat
2	Player	Edmondson, Reid	WE2771171MJ18			Y				C
3	Player	Bly, JOHNAUSTIN	WE2885213MJ18				Y			C
6	Player	De Wilde, Ian	WE2888929MJ18			Y				C
8	Player	Klidonas, Dylon	WE2886465MJ18				Y			C
10	Player	Ayers, Andrew	WE2889235MJ18							C
14	Player	Mullane, Andrew	WE3052210MJ18				Y			C
15	Player	Sproull, Elijah	WE2886657MJ18							C
17	Player	Dusza, Jonathan	WE2997823MJ18							C
19	Player	Conroy, Vincent	WE2992804MJ18							C
21	Player	Trenchard, Joshua	WE2999486MJ18							C
22	Player	Heleba, Ethan	WE2869684MJ18							C
41	Player	Elibol, Jacob	WE2891029MJ18			Y	Y			C
	Head Coach	Jack, David	WE1146399MR18	Eligible	IMPACT	Y		Y		C
	Asst. Coach	Schneider, Thomas	WE1312903MR18	Eligible	IMPACT	Y	Y	Y		C
	Asst. Coach	Earl, Katherine	WE2035497FR18	Eligible	IMPACT	Y		Y		C
	Asst. Coach	Schneider, Mary	WE2367696FR18	Eligible	IMPACT	Y	Y	Y		C
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: The above roster is correct and contains all players who will be participating in the event. All players meet age requirements. They will have in their immediate possession at all times during this competition a completed copy of the USAV Medical/Emergency Release Form for each player listed on the official roster. The team understands it is subject to any and all penalties if this roster does not match the participants attending the event, regardless of who signs this verification. ____________________________________________ ________________________________________________ Print Name Signature ____________________________________________ ________________________________________________ Phone Number (If different from above) Date