Long Island Volleyball Association


LONG ISLAND VOLLEYBALL ASSOCIATION4271 OAK BEACHOAK BEACHNY11702631-422-5555

11th YEAR !

Please fill out the following form. (Please note, it is very important that you call our office after you register to insure that we still have the space available to get you into the tournament). The red fields are required. The cost for a team is $35/player. You can also print out this form and mail it in with the registration fee.

Make checks payable to Make-A-Wish and send to LIVA. Thank you.

LIVA
4271 Oak Beach Rd
Oak Beach, NY 11702

Captain's Name:
Email:
Address:
City:
State:
Zip:
Tel. (Cell/Home#):
Tel. (Work#):
Team Name:

Skill Level:

Beginner

Advanced

Please include the rest of your roster.

Player 2
Name:
Email:
Address:
City:
State:
Zip:
Tel. (Home):
Tel (Work):

Player 3
Name:
Email:
Address:
City:
State:
Zip:
Tel. (Home):
Tel (Work):

Player 4
Name:
Email:
Address:
City:
State:
Zip:
Tel. (Home):
Tel (Work):

Player 5
Name:
Email:
Address:
City:
State:
Zip:
Tel. (Home):
Tel (Work):

Player 6
Name:
Email:
Address:
City:
State:
Zip:
Tel. (Home):
Tel (Work):

Player 7
Name:
Email:
Address:
City:
State:
Zip:
Tel. (Home):
Tel (Work):

Player 8
Name:
Email:
Address:
City:
State:
Zip:
Tel. (Home):
Tel (Work):

Player 9
Name:
Email:
Address:
City:
State:
Zip:
Tel. (Home):
Tel (Work):

Player 10
Name:
Email:
Address:
City:
State:
Zip:
Tel. (Home):
Tel (Work):

We will call you to confirm, once we receive the registration fee. Thank you.

LONG ISLAND VOLLEYBALL ASSOCIATION4271 OAK BEACHOAK BEACHNY11702631-422-5555

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