Team Name: ________________________________________
Preferred Division:
First Name
Last Name
Date of Birth
mm/dd/yy
Address
Phone #
Team
Captain
Alternate
Captain
Roster
** For insurance purposes, all team members’ information must be provided BEFORE they play volleyball at any City of Lethbridge facility
E-Mail Address
A
B
C
(circle one)
Emergency Contact
Name
Emergency Contact
Phone #