Desoto Chargers

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2017 Coaches Application

COACHES INFORMATION

* First Name:

* Last Name:

* Street:

* City:

* State:

* Zip Code:

* Best Contact Phone Number:

Cell Phone:

* Birthdate:

* Email:

* Gender:

* Position Requested:

* Requested Team:

* Shirt Size:

MEDICAL/EMERGENCY CONTACT INFORMATION

* Emergency Contact Name:

* Emergency Contact Phone Number:

* Your Relationship To Emergency Contact:

WAIVER INFORMATION

I, the above mentioned coach, understand that I must abide by the rules and regulations set forth by City of DeSoto Youth Football and Cheerleading athletic/sports program and the Desoto Chargers Football/Cheer Organization before, during and after all practices and games. In case of an accident or illness, I authorize the calling of medical services. I will not hold the Desoto Chargers Football/Cheer Organization or any of their emissaries responsible in case of an accident. In the event that medical emergency attention is deemed necessary, I give permission for medical treatment to be administered by a physician/hospital/clinic or EMS personnel. By my signature and of my free will I do hereby agree to indemnify and hold harmless the Desoto Chargers Football/Cheer Organization and any of their emissaries from any and all claims and demands, cost or expense arising out of any injuries sustained by myself or any party that I am responsible to or for. I give permission for the taking and usage of photos by the Desoto Chargers Football/Cheer Organization.

I further agree to each of the following:

I agree to complete a background check form.

I understand that I will be allowed to coach only after a background check has been completed and meets the approval of the Desoto Chargers Board members and the City of DeSoto Youth Football and Cheerleading athletic/sports program.

I agree to adhere to all of the rules as written without exception.

I understand that any rule not written or stated is left to the discretion of the Board members of the Desoto Chargers Football/Cheer Orgination and the City of DeSoto Youth Football and Cheerleading athletic/sports program.

I accept responsibility for the conduct and action of myself and or my team

By checking this box I agree that this will substitute as my orginal signature.

I/we agree with the above *

* indicates required fields

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2017 Coaches Application