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Football is a very physical sport. On occasion injuries occur. It is important that we have emergency contact and medical information so that we can best assist you in case of injury or emergency. Please complete the following information.
*
Indicates required field
Players Name
*
First
Last
Team
*
Az Heat
Az Roll Tide
Az Buffs
Gilbert Thunderbirds
Phoenix Phantoms
Tama Toa
Texas Raptors
Valley Venom
West Valley Vengeance
FIRST EMERGENCY CONTACT
Emergency Contact- Name
*
First
Last
Emergency Contact- Phone Number
*
Relation to You
*
Parent
Sibling
Spouse
Grandparent
Significant Other
Friend
Relative
Child (15 yrs or older)
SECOND EMERGENCY CONTACT
(not required)
2nd Emergency Contact
*
First
Last
2nd Emergency Contact-Phone Number
*
2nd Emergency Contact: Relation to You
*
Parent
Sibling
Spouse
Significant Other
Friend
Relative
Child (15 yrs and older)
Insurance Information
Do you have medical insurance:
*
Yes
No
Insurance Carrier
*
Insurance Member ID #
*
Can you take Ibuprofen?
*
Yes
No
Medical Information -
It is important that you disclose any pre-existing condition and medical allergies so that emergency medical providers can provide the best care.
Please let us know if you have any pre-existing conditions:
*
None
Respiratory
Diabetes
Spinal Issues/Injuries
Epilepsy
Concussion(s)
Hyper Tension (High Blood Pressure)
Heart Murmurs
Coronary Artery Anomolies
Hypertrophic Cardiomyopathy (HCM)
Please list any other medical conditions or medical allergies emergency medical providers may need to know prior to treating you:
*
Submit
Home
2026 AAAFL TEAMS
GAME REQUESTS
AAAFL PLAYERS
2026 Player Registration
ALLIANCE BOWL
ALL STAR GEAR
TEAM FEE (Owners Only)
Breast Cancer Honors
Advisory Board
AAAFL FAN GEAR
CONTACT US