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Coaches Form

Coach Information

* First Name:

* Last Name:

* Street:

* City:

* State:

* Zip Code:

Home Phone:

* Cell Phone:

* DATE OF BIRTH:

Email:

* Jersey Size:

Gender:

* Age Division:

4U

6U

8U

10U

12U (may travel)

14U (may travel)

Team Name (s):

Assistant First name:

Assistant Last name:

Email:

Home Phone:

Work Phone:

Assistant T-Shirt Size (only Main Coach gets Jersey):

Cell Phone:

Emergency Contact:

Phone:

Relationship to Coach:

Insurance Carrier:

Policy #:

WAIVER INFORMATION

I understand that I am in the position to set an example and I will follow the coaches code of conduct, I will not cause drama or turmoil on social media or on the field, I will respect all referees, I will keep good communication with parents, I will respect all players, and I will play all players 50% of the time. I will also attend the mandatory coaches meetings and take the mandatory coaches classes as needed, asked, or required!

I/we agree with the above *

* indicates required fields

Additional Small Jersey($20)

Additional Medium Jersey($20)

Additional Large Jersey($20)

Additional XL Jersey($20)

Additional 2XL Jersey($20)

Additional 3XL Jersey($20)

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