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Registration 2024
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Home
About Us
Our History
Our Staff
Sponsors
Gallery
FAQ
Our Teams
Contacts and Fields
Registration 2024
Staff Registration
General Info
* Please note that the information you provide will also be shared with our athletic therapists *
Name
*
First
Last
Address
*
Street Address
App.
City
State / Province / Region
ZIP / Postal Code
Email
*
Phone
*
Birthdate
*
DD slash MM slash YYYY
Medicare card
*
Role
*
Coach
Assistant Coach
Manager
Coaching #
EMERGENCY CONTACT
Name
*
First
Last
Phone
*
MEDICAL INFORMATION
Medical condition
*
Please list all known allergies
*
Please list all medications, including for asthma:
*
*
As a volunteer for the Greenfield Park Packers Football Association, I hereby consent for the executive board to conduct a background check for security purposes.
*
I hereby pledge to abide by and uphold the values and standards of the following at all time: 1-Association's Contitution; 2- Green & Gold Code
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Player Registration