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Coaches Form
Coach Information
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First Name:
*
Last Name:
*
Street:
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City:
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State:
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Zip Code:
Home Phone:
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DATE OF BIRTH:
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Cell Phone:
Email:
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Jersey Size:
Small
Medium
Large
X Large
XX Large
XXX Large
XXXX Large
Gender:
M
F
*
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):
Small
Medium
Large
X Large
XX Large
XXX Large
XXXX Large
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)