2021 Volunteer Coach Background
Consent/Release Form
Email *
Applicant's LAST Name *
Applicant's FIRST Name *
Applicant's MIDDLE Name
Football or Cheer Coach *
Division
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Team Name
Position *
Male or Female *
Race (Check one) *
Street Address - City, State Zip *
Date of Birth *
MM
/
DD
/
YYYY
Social Security Number *
Phone Number *
Have you ever been convicted of a felony? *
If yes, Please explain:
Authorization/Consent
By submitting this form, I hereby authorize and give consent for the Marion County Youth Football League to obtain information regarding myself.  This includes the following:  criminal background records, sex offender registry checks, addresses, social security verification.  I authorize this information to be obtained either in writing or via telephone in connection with my application.  Any person, firm, or organization providing information or records in accordance with this authorization is released from any and all claims of liability for compliance.  Such information will be held in confidence in accordance with the organization's guidelines.
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