Your Name:
Your Email Address:
Father's Occupation:
Mother's occupation:
Player's name:
List any medical conditions:
Doctor's Name:
Doctor's Phone:
Emergency Contact Name:
Emergency Contact Phone Number:
Are you willing to be the team coach?
Are you willing to be an assistant coach?
Are you willing to be the team monitor?
Are you willing to organize the team's stock share sales activities?
Are you willing to be a team helper (phone calls, chain gang, etc.)?