Please select the level you would like to volunteer to help with.*Atome U-10Mosquito U-12Peewee U-14Bantam U-16Midget U-18Valkyries U-18Position requested*Team ManagerTrainerOtherDo have a valid Standard First Aid with CPR certificate? Yes No Name* First Last Birth Date*DDDD12345678910111213141516171819202122232425262728293031MMMM123456789101112YYYYYYYY202720262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920dd/mm/yyyyRAMQ #*Format : AAAA-1111-1111NCCP/ PNCE #Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Cell Phone*Work PhoneHome PhoneEmail* CRIMINAL BACKGROUND CHECK* I consent to a criminal background checkOMFA will engage the services of a local police force to run "vulnerable sector" criminal background checks on all volunteers working directly with children. OMFA Code of Conduct* I have read I have read and agree to abide by this Code of Conduct while a member of the OMFA.Click here to read the policy:OMFA Code of ConductAFMO Informed Consent about Concussions or Head Injuries for coaches and volunteers* I have read and understand this consent form, and I volunteer to participate.Click here to read the policy:AFMO Informed Consent about Concussions or Head Injuries for coaches/volunteersPHOTO RELEASE APPROVAL (condition)* I accept the terms below By registering myself, I grant the Outaouais Minor Football Association unrestricted authority to use for media purposes (web, newspaper, etc.), promotional usage and communication to the public any photo or audio-visual material of my child taken during activities sanctioned by the OMFA (selection camps, training sessions, off-season and regular season games, etc.). I understand that I will receive no compensation should the said material be used for the stated purposesRESPONSIBILITY WAIVER (condition)* I accept the terms below I release the administrators, coaches and volunteers of the OMFA of all responsibility in the case of injury, loss or damage to the person in result from my participation. CERTIFICATION* I accept the terms below I hereby certify that the above information is true and that I have read and fully understand the conditions set out in this document. I agree to abide by the conditions, regulations and codes of conduct of the OMFA and Football QC.