2021 JVA Coaches Event Sign-in Form
This tournament is insured by JVA. It is required that each member of the team have a signed JVA Waiver of Liability Form and a JVA Medical Waiver and Release Form* and that a hard/electronic copy of the form is in the possession of the coach/team rep at all times or available online via SportsEngine.
If an individual is injured during participation in this event, it is the coach’s responsibility to secure a “JVA Incident Report” from the Tournament Director. The form should be completed and retained by the Tournament Director. It is advised that the coach keep a copy for the club records. Medical Claims for insurance coverage cannot be honored without an Incident Report from. A Medical Claim form can be requested from Lisa Wielebnicki via email at firstname.lastname@example.org.
By signing this form, you are taking responsibility that anyone on your bench is on your submitted roster. Also, you are agreeing that you have completed all requirements of the JVA Background Screen and JVA Safety Policy.
The coach assumes responsibility to have access to the above-named forms at all times.
*A USAV Medical Waiver and Release Form is acceptable.
Name of Event
2021 March Mania
2021 Diggin in the Dells 1
2021 Diggin in the Dells 2
2021 MW JVA Challenge
2021 Youth Showcase
All TEAM names (not players) if you are filling out for entire club: