2023 Midwest Championships "The Fiesta" Verification

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Club Director or Club Representative* This field is required.Full Name
First Name
Last Name
2
Which club are you representing?* This field is required.
3
How many teams from your club will be participating?* This field is required.
4
As the club's Authorized Representative I assume all liability and attest that all adults working with my club's teams and the minor athletes therein at the 2023 Midwest Championship "The Fiesta" Volleyball Tournament are in full compliance with the "... Safe Sport Act of 2017." Further, I have read, all JVA insured event requirements and will supply any and all forms to the event upon request, including but not limited to, JVA Event Waiver, Medical Forms for each athlete and any and all items needed to confirm compliance with the JVA's Background Screening and APS Policy.* This field is required.
I agreeNo
5
As the club's Authorized Representative I attest that the individuals on the roster as established and furnished to JVA, AAU or USAV are the athletes that will be in attendance and participating in the event. If, due to illness, an athlete is unable to attend and the team has less than six players, I will contact the event director immediately to request an addition to the roster to ensure participation.* This field is required.
I agreeNo
6
Signature* This field is required.
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