Foreign Team Compliance Form

____________________________________________________________________________

Full Team Name (include club name, team name and age level):

Forms to be filled out and returned by Jan 21, 2012:

1) This form – One per team required

2) 2012 Team Registration/Summary – One per team required

3) 2012 Individual Registration form – 3 pages, first two required for ALL participants, last page is information only

4) 2012 Player Medical Release form – required for all players

Items/Information to be obtained by the team and sent by Jan 21, 2012:

5) Copy of government issued photo id – one per player

6) $100.00 US Insurance fee. (For Canadian teams, in Lieu of the $100 insurance fee, proof of 24/7 health insurance valid in the US - required for ALL PARTICIPANTS. If the Health Sante Card has a current photo on it, it will suffice for both 5 and 6. Only the front of the card need be photocopied.)

7) Letter from Governing Volleyball Association stating that all members of the team are registered and in good standing.

Mail to:

Rose Atkinson

2445 Jalice Cir.

State College, PA 16801

When mailing packages, you MUST waive the signature or it may not be left at our office. For Canadian Teams this means WAIVE the delivery confirmation.

As a representative of the above team, I declare that all seven required components of the Foreign Team Entry listed above have been submitted to the NN. If any parts are missing and/or incomplete, I personally guarantee those parts will be brought to the tournament and turned in upon check-in Saturday morning prior to our first match.

I assume full responsibility for missing and/or incomplete parts.

I understand that missing signatures and empty blanks can signify incompleteness.

I understand that incompleteness can cause the participant and/or team and/or club to be disqualified from participation in this season’s NN and/or future USAV events.

I understand that the team is ineligible to participate until all the missing/incomplete parts are turned in, possibly longer.

I assume all responsibility for any and all disciplinary action taken against the above stated team due to failure to submit a complete and accurate set of required information.

________________________________ ___________________________________ ____________

printed name signature date