Marine Officer Screening Questionaire

This document is to show that the person mentioned below has provided on their own one or more piece of equipment required to participate in OSA Tackle Football.
Parent Name*

First NameLast Name
Cell Phone Number*

Area CodePhone Number
Email*
example@example.com
Players Name *

First NameLast Name
Age Group Playing (6U, 7U, etc)*
HelmetChin StrapShoulder Pads
I am aware that OSA Tackle Football is not liable for any injuries caused by faulty or improperly fitted equipment. I am also aware that OSA Tackle Football provides certified equipment fitted by USA football certified staff. I have CHOSEN NOT to use league issued equipment.
Signature*

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Date*

MonthDayYear
Date
Should be Empty: