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Tri-Hamlet Sports Club
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Coach Membership Form
COACHES INFORMATION
*
First Name:
*
Last Name:
*
Birthdate:
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Gender:
M
F
*
Division being coached (check all that apply):
Tee Ball
*
Double A
*
Triple A
*
Travel
*
*
Shirt Size:
Youth XS
Youth S
Youth M
Youth L
Youth XL
Adult S
Adult M
Adult L
Adult XL
*
Street:
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City:
*
State:
*
Zip Code:
*
Cell Phone:
Work Phone:
*
Home Phone:
*
Email:
*
Name of team you want to coach:
*
Name of player you are related to:
MEDICAL/EMERGENCY CONTACT INFORMATION
*
Phone:
*
Emergency Contact:
*
Player you are attached to:
Please add any information on any existing Medical Conditions to the comments field For example: Asthma, Diabetes, Arrhythmia.
Existing Medical Conditions:
WAIVER INFORMATION
AS A CONDITION OF VOLUNTEERING, I give permission for the Tri-Hamlet Sports Club to
conduct background check(s) on me now and as long as I continue to be active with the
organization, which may include a review of sex offender registries, child abuse and
criminal history records. I understand that, if appointed, my position is conditional upon
the Club receiving no inappropriate information on my background. I hereby release and
agree to hold harmless from liability the Tri-Hamlet Sports Club, Incorporated, the
officers, employees and volunteers thereof, or any other person or organization that
may provide such information. I also understand that, regardless of previous
appointments, Tri-Hamlet Sports Club is not obligated to appoint me to a volunteer
position. If appointed, I understand that, prior to the expiration of my term, I am
subject to suspension by the President and removal by the Board of Directors for
violation of policies or principles.
I/we agree with the above
*
* indicates required fields