EMSA ID Card Application Form

Who Needs an EMSA ID Card? - INDOOR 2023/24

COMMUNITY LEAGUE

Community Players U13 to U19

Community Coaches U5 to U19

CLUB LEAGUE

Premier Players U11 to U19

Premier Coaches U9 to U19

In submitting this form we will ensure that your players EMSA ID card is up to date on the EMSA Soccer portal and will advise coaches to print their player card information prior to the game to show the referees, physical cards will only be printed if the team advances to Provincials in which case a physical card will be needed.

Zone *

Applicant First name *

Applicant Last Name *

Applicant Date of Birth * +

Please provide your contact email (we will use this in the event there is an issue with the submission) *

Please upload a picture government proof of age (AB Health card, Drivers License, passport) - JPEG format only *

Please provide a headshot or selfie that will be put onto your EMSA ID Card (JPEG only) No hats, hoods, sunglasses allowed, No hands covering face, it must be taken from the shoulders up, must have some kind of clothing on like a t shirt covering shoulders * 🛈

If your file is too big to attach - please email the photos & government proof of age to Cindy: staff@emsanorth.ca

Declaration of Information

Declaration on Information *

By Clicking this form I am confirming that I am over the age of 18 or the parent/guardian of any player under the age of 18 and that the information provided is accurate and true.

Declarers First name *

Declarers Last name *

Declarers Signature *

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