Edward Murphy

* Indicates required field

Upcoming Presentation

Location: Edward Murphy Elementary School
Date: Monday Jan 18th 2016
Time 12:50am - 1:40pm

By filling out the following form, you commit to presenting the Concussion Legacy Foundation presentation. Since there is a limited space, we will contact you to confirm that you will be presenting. If you do not get selected as a presenter, you are still welcome to come watch how its done! This is a great way to learn to how things work. Please note that only certified concussion educators will be selected to present.

Name *

First

Last

Email *

Please let us know your indented role for the presentation: *

I am a trained educator and agree to present the day of, and practice once before with my group. If I don't get selected to present, I would still like to attend the presentation. I am not trained or don't feel ready to present, but would like to watch the presentation.

Concussion Educator ID (i.e. M11501) *

Thank you for filling out this form. We will get back to you closer to the day of the presentation.

Submit