Truro Minor Football Association (TMFA)
Confidential Participant Information

Please provide your email address to receive team announcements and schedule updates.
Note, all fields marked with a red * are required or form will not submit.

Player Name* Player Birth Date (d,m,y):*  Player Address:*  Postal Code:* Player Telephone:* Cell Phone: Email Address:* Parents/Guardians:* Family Doctor:* Family Doctor telephone:* Health Card Number:* Expiry Date:* In case of emergency contact:* Relationship:* Home Telephone:* Work Phone:* Cell Phone: Medical Concerns(Asthma, Diabetes, Epilepsy, Allergies, etc: List any medications: Any previous injuries/disabilities: I hereby certify that I am the parent/guardian of:* (Participant's Name) who is under the age of 19 years of age and I hereby consent to any emergency medical procedures which may be deemed by a licensed medical practitioner as a result of his involvement in a sport activity. Parent/Guardian Name:* Date:* Witness:*

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