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Coaches Fall 2024 application

Applicants Information

"COACHING IS TAKING A PLAYER, WHERE THEY CAN'T TAKE THEMSELVES."

* Position:

Head Coach

Assistant Coach

* Age Group:

* First Name:

* Last Name:

* Birthdate:

* Physical Address:

* City:

* State:

* Zip Code:

Home Phone:

* Cellphone Number:

* E-mail:

* Gender:

* Jersey Size:

* Child's Name (If Applicable):

I have read the LSSA Liability Waiver and Release form and, fully understand its terms, I understand that I have given up substantial rights by signing or selecting the agreement box, freely and voluntarily without any inducement. *

* indicates required fields