Fillable Printable Official Youth Scholarship Certificate

Official Youth Scholarship Certificate

OFFICIAL

YOUTH SCHOLARSHIP CERTIFICATE

Entitle Youth Coaches to FREE Admission

at the Glazier Clinics

Youth Coach - Please ll out the information below

Please make copies

as needed for all

youth coaches.

Name (First, Middle Initial, Last):

Address:

City:

State:Zip:

Home Phone Number:

Work Phone Number:

E-mail Address:

Youth Football Organization Name:

Youth Football Organization City:

Youth Football Organization Phone Number:

The Glazier Clinics and Riddell

, Inc., strongly believe that youth football and its volunteer coaches are the foundation of football. Free admission to the

Glazier Clinics is offered to each volunteer youth football coach (as a guest of Riddell

) who initials each statement below and signs this affidavit. This

signed affidavit must be submitted to onsite registration to receive an attendee badge under the Riddell® Youth Scholarship Program.

I understand that the Riddell

Youth Scholarship fund is only available to coaches who do not coach at a school.

I understand that High School and Junior High volunteer coaches are not eligible under the rules of this scholarship program.

I understand that if I coach at a qualified youth program and also coach at a school program, I am not eligible.

I agree that Glazier Clinics will be damaged if I use a youth scholarship under false pretenses.

I agree to pay $500 plus legal/recovery costs if I use this scholarship under false pretenses.

I understand that if I enroll in this scholarship program under false pretenses, an ethics complaint will be filed with my school.

I confirm that I do not have an affiliation with any high school or college program.

I agree that to misrepresent my coaching activities will damage the Glazier Clinics and Riddell

, Inc., as well as

endanger the future of the Youth Football Scholarship Program.

Photo identification required. Must be signed in the presence of clinic personnel.

Signature:

Riddell

Rep Name:Signature:

Driver’s License Number:

Date:

________________________________________________________________________________________

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For more information, visit glazierclinics.com.