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Life Sports Athletic Trainer Volunteer Application

2. Life Sports Athletic Trainer Volunteer Application

4. First Name*

5. Last Name*

7. Date of Birth*
   Date of Birth

8. Phone Number*

9. Email Address*

11. Address*

13. Address Continued

15. City*

16. State*

17. Zip*

19. Please List Any Medical Certifications or Licenses You Have*

    If possible, please email a copy of your certifications and licenses after you complete the form to lifesports@bluespringsgov.com.

21. Dates You Can Volunteer*

    1. Monday June 21, 2021
    2. Tuesday June 22, 2021
    3. Wednesday June 23, 2021
    4. Thursday June 24, 2021
    5. Friday June 25, 2021
    6. Monday July 12, 2021
    7. Tuesday July 13, 2021
    8. Wednesday July 14, 2021
    9. Thursday July 15, 2021
    10. Friday July 16, 2021

22. T Shirt Size*
    -- Select One --Adult SmallAdult MediumAdult LargeAdult XLAdult 2XLAdult 3XLAdult 4XL

24. Upload a copy of your License / Certifications

26. By Checking this Box, you agree to allow the Blue Springs Police Department, Life Sports Staff, to run your name through the computer to check for wants / warrants, or anything that would lead to your interacting with children to be unadvisable.*

    1. I agree with the above statement

Leave This Blank:


28. 1. Receive an email copy of this form.
29. Email address

    This field is not part of the form submission.

30. Submit

* indicates a required field