2024 JVA INSURED TOURNAMENT COACHES' FORM
This tournament is insured by JVA. It is required that each member of the team has signed the JVA Waiver of Liability Form electronically and that it can be accessed through the JVA registration.
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 form. 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
Name of Event
2024 Blues City Pres Day Memphis1
2024 Dells President's Day
2024 Diggin Dells 2
2024 Diggin Dells 1
2024 March Mania
2024 MEMPHIS BLUES
2024 MW Challenge
2024 Showcase in the Dells
2024 UNI-Dome JVA Challenge
2024 Youth Showcase in the Dells
TEAM names (NOT PLAYERS) listed below - one team per line
For more information on the Junior Volleyball Association (JVA) go to http://www.jvaonline.org
Contact with Questions:
Lisa Wielebnicki, JVA Director of Member Development
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