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2024 Region V Soccer
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< Insert League Name >
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Club Roster
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TEMPLATE ONLY! GO TO FILE > MAKE A COPY.
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Institution: Division:
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Club Team:Email:
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Team Rep:Phone:
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Address:
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All participants must comply with the NIRSA Championship Series Eligibility Guidelines. Players with questions about their eligibility or who have need for additional support are encouraged to contact the NIRSA Director of National Sport Programs Nicole Jackson.
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Please list players in ascending order by jersey number; Roster limit – 25 players.
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PlayerJersey #Participant Name

(Typed)
Former Collegiate Varsity Player# Years on a NIRSA Roster# Years on a Varsity Roster/Squad ListEmail Address

(Typed)
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1YES / NO
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2YES / NO
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3YES / NO
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4YES / NO
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5YES / NO
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6YES / NO
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7YES / NO
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8YES / NO
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9YES / NO
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10YES / NO
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11YES / NO
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12YES / NO
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13YES / NO
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14YES / NO
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15YES / NO
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16YES / NO
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17YES / NO
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18YES / NO
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19YES / NO
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20YES / NO
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21YES / NO
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22YES / NO
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23YES / NO
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24YES / NO
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25YES / NO
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By signing this statement of eligibility, I ________________________________ (name of Club Sport President, Officer, Coach, or Representative), have conferred with the team captain to attest that each member of this roster has not already appeared on six varsity or NIRSA Regional Tournament rosters. All names listed on this roster meet each NIRSA eligibility guideline.
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Email:
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Signature of Club Soccer Representative Approving Team Entry
Phone:
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By signing this statement of eligibility, I, _______________________________________, have confirmed with the team representative to attest that each member is eligible to compete this Fall 2024 Region V Soccer season.
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Signature of League Commissioner Approving Team Entry
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