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St.
Clement Parish Athletic Committee
Team Mom/Dad Application
NAME________________________________________
HOME ADDRESS_______________________________________
CITY__________STATE_________ZIP____________HOME PHONE______________
E-MAIL ADDRESS________________________ CELL PHONE _________________
ST. CLEMENT PARISH MOM/DAD RESPONSIBILITIES
- Help assist coach with phone calls (practice, games + fund raisers)
- Table duty (coordinate work bond responsibilities)
- Front door (collecting admission for 5th- 8th grade games)
- Committee help
I herby attest and certify that I have not been accused or convicted in the
State of New Jersey or any other state or jurisdiction of any crime or
disorderly persons offense involving sexual offenses, child molestation, DWI,
endangering the welfare of children or incompetents, arson, armed robbery,
aggravated assault, kidnapping , murder, manslaughter or violations of the New
Jersey Controlled Dangerous Substance Act.
I have read, understand, attest and certify to the above.
Applicant Signature_____________________
Date ___________________________
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