P.V.J.S.L Player Waiver Form - Fall 2017

 

Player’s Name:

 

Player’s Phone #: ( ) -        Player’s B.O.B: / / (mm/dd/yyyy)

 

Player’s Address:

City:                      State: Zip

 

Request Transfer From:    

                                                    Organization Name                                                       Age Group and Division

Request Transfer To:       

                                                                     Organization Name                                                       Age Group and Division

 

Reason For Requesting Waiver

  1.  A player involved in divorce or custody circumstances,
  2.  A school choice student playing for a team in the town where he/she attends school

                   [a letter from the school must be attached]

  1.  A player on a team affiliated with a church, temple, or fraternal organization where

             the player or a parent is a member

  1.  A player that has no age appropriate team in the player’s city or town or there is no

            room on an age appropriate team in that city or town (this has nothing to do with the

            players division).

  1. Reason other than those listed :
         

 

        ______________________________________________________________________________                           

                        Signature of Player                                                                                                                          Date

 

        ______________________________________________________________________________                           

                        Signature of Parent                                                                                                                          Date

 

        ______________________________________________________________________________       Approved  /  Denied                    

                         Signature President of Organization Transferring From                                                              (Circle one)                 Date

 

        ______________________________________________________________________________       Approved  /  Denied                    

                         Signature President of Organization Transferring To                                                                 (Circle one)                 Date

 

        ______________________________________________________________________________       Approved  /  Denied                    

                         Signature of Registrar P.V.J.S.League                                                                                          (Circle one)                 Date