Penn Manor Football Contact Info. Form
We apologize to those players who have already submitted this information to Coach Brubaker. We are trying to streamline our contact information in the hope of providing better communication throughout the season.

Please provide the following contact information.
Data collected will be kept confidential for Penn Manor Football coaches and board use only.
Please enter all requested information in full.

PLEASE NOTE: This form does NOT replace the PIAA required information with regards to emergency contacts.

PLAYER First Name: *
Your answer
PLAYER Last Name: *
Your answer
GRADE (FALL 2018) *
PLAYER E-MAIL: *
Full email including extension. Example: jonsmith@gmail.com
Your answer
STREET ADDRESS: *
House # and Street Name Only
Your answer
CITY: *
City Only
Your answer
STATE: *
State Only
Your answer
ZIP: *
ZIP # Only
Your answer
PLAYER MOBILE PHONE NUMBER:
10 digit number enter as: ###-###-###
Your answer
MAIN PHONE # TO REACH PLAYER (Home or Cell): *
10 digit number enter as: ###-###-###
Your answer
GUARDIAN #1 FULL NAME: *
Example: Mary Smith
Your answer
GUARDIAN #1 RELATION TO PLAYER: *
Please choose from list
GUARDIAN #1 E-MAIL *
Your answer
GUARDIAN #1 PHONE: *
10 digit number enter as: ###-###-###
Your answer
GUARDIAN #2 FULL NAME:
Example: George Smith
Your answer
GUARDIAN #2 RELATION TO PLAYER:
Please choose from list
GUARDIAN #2 E-MAIL:
Your answer
GUARDIAN #2 PHONE:
10 digit number enter as: ###-###-###
Your answer
Notes
Optional: Additional contact details, comments, allergies
Your answer
It takes a team to make our football program a success. Each family can help in small and large ways. Please select the events or committees that you are willing to help volunteer.
We ask that all families volunteer in at least one position or event. With players graduating, we are in need of underclass parents to dive in and learn the responsibilities of each position.
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