Box 5 - Credential & W-9 info

Box 5 - Credential & W-9 info
Full name as appears on your State Issued ID*

PrefixFirst NameMiddle NameLast NameSuffix
Date of Birth*

MonthDayYear
Gender*
This is required for your credential to the game.
Home Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Cell Phone Number*
Email*
example@example.com
If you do not have a current staff jacket, please indicate your jacket size.
Please upload a passport quality & format photo.
This means:
- White Background
- No Hats & Sunglasses
- Top of shoulders and above
*This can be taken with your cell phone as long as it meets the requirements.
Photo Upload

Photo must be under 1000 KB
Cancelof
Waiver and Hold Harmless

The following Terms & Conditions are required by the insurance companies and by our partner's legal council.

ANSWER ALL QUESTIONS TRUTHFULLY AND COMPLETELY. Candidates may be rejected if they have intentionally made a false statement of a material fact, or have practiced or attempted to practice deception or fraud*

	Yes	No
Have you ever been arrested?
Have you ever been convicted of a crime involving violence or threat of violence?
Have you ever been convicted of a crime involving criminal activity in drugs or alcoholic beverages?
Have you ever been convicted of a sex-related crime?
Have you been or are you currently on a sex offenders registry?
Have you ever been convicted of any other crime except a minor traffic violation? (Includes Traffic Crimes)

If you answered yes to any of these questions, please provide details*
After clicking submit, you will be sent to a page to complete your W-9 form. We need a new W-9 form each year.
Should be Empty:

Box 5 - Credential & W-9 info

Please upload a passport quality & format photo.

Waiver and Hold Harmless