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Club Team Coaching Declaration

YES I coach a club team on which PSAs participate

YES I coach a club team but no PSA-aged individuals participate

NO I do not coach an outside club team

Club team players within 50 mile radius - Bylaw 13.11.2.3

I affirm that the participants on the club team that I coach:   (team name), all live within a 50 mile radius of the club, unless this club is the closest opportunity for them to participate in this sport.

I have attached a roster of my club team, including their addresses. If any participants live outside the 50 mile radius, please document that on the roster.

Name:

Date: