Volunteer Application

Coaching Application

If you are a human and are seeing this field, please leave it blank.

Fields marked with a * are required

Full Legal Name *

Date *

Other Name(s)

Cell Phone *

Home Phone

Work Phone

Home Address *

Mailing Address

Prior Volunteer Positions:

Boys

Girls

Coed

6-7 Yr Olds

8-9 Yr Olds

10-11 Yr Olds

12-14 Yr Olds

Positions Held:

Head

Assistant

If Assistant, with whom?

Other Volunteer Experience:

Qualifications:

What other sports have you coached? (Sport, Age, Level, # of years)

If yes, Card Level/Title:

CPR/First Aid Card Expiration:

If yes, Training Name:

Date of Training:

If yes, please list names:

If yes, please explain:

Why do you want to be a volunteer coach? *

Why are you qualified to coach? *

References:

Reference 1 Name: *

Reference 1 Phone: *

Reference 2 Name: *

Reference 2 Phone: *

Acknowledgement of Training:

I acknowledge that on

(date)

I was given a copy this agreement provided by the Fast Break Youth Basketball program and that I have carefully reviewed it and voluntarily agree that as a condition of future participation, employment, or involvement with Fast Break Youth Basketball program. I will abide by all of the terms, conditions, policies, and procedures contained within this document. If my actions as a coach are not in compliance with the policies or regulations of this program, I shall indemnify and hold harmless the Fast Break Youth Basketball program, its employees, board members, volunteers, and officials from any and all liability resulting from my intentional tortious actions.

I Acknowledge *

Image Release:

I consent and hereby grant to the Fast Break Youth Basketball program, its’ Officers, Agents, Employees and Assigns the right to take photographs of me in connection with my role as a volunteer coach. I understand that this photograph and/or other digital reproduction may be utilized for all publication processes, whether electronic, print, digital or electronic publishing via the internet. I understand that I will not receive payment from any party. By signing this form, I confirm that this consent form has been explained to me in terms which I understand.

I Acknowledge *

Code of Ethics:

As a volunteer coach for the Fast Break Youth Basketball program, I promise to set a good example for my team at all times. I will demonstrate and promote good sportsmanship in every aspect of the sport, use appropriate language at all times, and will encourage positive attitudes by using constructive criticism. I will provide all team members equal opportunity to learn and experience the sport regardless of their age, race, gender, disabilities, orientation, or income status. I will consider the safety of all participants to be the top priority of the program, followed by good sportsmanship and fair play. I will remember that the program is designed for children and not adults, as a fun, rewarding, and educational experience, with emphasis placed on absorbing the fundamentals of the particular sport, not on winning at all costs. I hereby pledge to provide positive support, care, and encouragement to my team by following the Fast Break Youth Basketball program Coaches Code of Ethics outlined.

I Acknowledge *

Release Hold Harmless and Agreement Not To Sue Volunteer Form:

I fully understand that I am voluntarily participating (volunteering) for FAST BREAK YOUTH BASKETBALL officers, directors, members, employees, and contractors and I hereby release, discharge and agree not to sue FAST BREAK YOUTH BASKETBALL officers, directors, members, employees, and contractors for any injury, death or damage to or loss of personal property arising out of or in connection with my participation.
In consideration for being permitted to participate for FAST BREAK YOUTH BASKETBALL, I hereby agree, for myself, my heirs, administrators, executors and assigns, that I shall indemnify and hold harmless FAST BREAK YOUTH BASKETBALL officers, directors, members, employees, and contractors from any and all claims, demands, actions or suits arising out of or in connection with my participation.

I hereby acknowledge that I am voluntarily participating for FAST BREAK YOUTH BASKETBALL and agree to assume any and all risks.

I HAVE CAREFULLY READ THIS RELEASE, HOLD HARMLESS AND AGREEMENT NOT TO SUE AND FULLY UNDERSTAND ITS CONTENTS. I AM AWARE THAT IT IS A FULL RELEASE OF ALL LIABILITY AND SIGN IT ON MY OWN FREE WILL

Date: *

Digital Signature: *