LVC 16 BLACK - Team Roster
Tournament Site: _______________________________________Tournament Date: ___________
Club: LOCKPORT VOLLEYBALL CLUB Team Rep: Thomas Schneider
Team: LVC 16 BLACK6313 Green Valley Ln
Team Code: MJ6LOCKP1WE Lockport, NY  14094
Region Division: Boys' 16's716-310-2781
Event Division Entered: __________________________________Email:
#PosNameUSAV # Coach
2  Player Cramer, Zachary WE2888854MJ19 C
4  Player Fish, Logan WE2885134MJ19 Y C
6  Player De Wilde, Ian WE2888929MJ19 Y C
8  Player Nicometo, Joseph WE2656094MJ19 C
15  Player Clouse, Jacob WE2646147MJ19 Y C
16  Player Edmondson, Reid WE2771171MJ19 Y C
21  Player Oneill, maverick WE3139689MJ19 C
22  Player Rooney, Jack WE2901874MJ19 Y C
44  Player Croff, Adam WE2793521MJ19 Y Y C
93  Player Micciarello, domenic WE2887373MJ19 Y C
99  Player Converse, Bradley WE2869733MJ19 Y C
 Head Coach Jack, David WE1146399MR19 Eligible IMPACT Y Y C
 Asst. Coach Schneider, Thomas WE1312903MR19 Eligible IMPACT Y Y Y C
 Asst. Coach Whiting, Matthew WE2996065MR19 Eligible IMPACT Y Y C
 Asst. Coach Wadhams, Ben WE2716285MR19 Eligible IMPACT Y C
 Asst. Coach Schneider, Megan WE1312899FR19 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.
Print NameSignature
Phone Number (If different from above)Date

Powered by