Riptide Coaching Application Form Applicant's Information * First Name Last Name Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Phone * (###) ### #### Email * Shirt Size * Small Medium Large Extra Large XXL CPR and/or First Aid certified? * If yes, please attach photocopy. Yes No Please list any children you have playing in Riptide Baseball. Child's Name First Name Last Name Age Group 7U 8U 9U 10U 11U 12U 13U 14U Child's Name First Name Last Name Age Group 7U 8U 9U 10U 11U 12U 13U 14U Child's Name First Name Last Name Age Group 7U 8U 9U 10U 11U 12U 13U 14U What position are you volunteering for? * Head Coach Assistant Coach What age group(s) would you like to coach? * 8U 9U 10U 11U 12U 13U 14U Employment Information * Employer: Work Phone * (###) ### #### Work Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Occupation/Position * Years Employed * Qualifications * Do you have coaching experience? Yes No Please list the 3 most recent Baseball coaching positions you have held. From: MM DD YYYY To: MM DD YYYY Age Group 7U 8U 9U 10U 11U 12U 13U 14U Coaching Position Head Coach Assistant Coach Other From: MM DD YYYY To: MM DD YYYY Age Group 7U 8U 9U 10U 11U 12U 13U 14U Coaching Position Head Coach Assistant Coach Other From: MM DD YYYY To: MM DD YYYY Age Group 7U 8U 9U 10U 11U 12U 13U 14U Coaching Position Head Coach Assistant Coach Other Have you ever played Baseball? * Yes No Have you ever Officiated Baseball? * Yes No Please list any experience you may have coaching other sports. Why do you want to be a volunteer coach for Riptide Baseball? * Personal References * Contact Name: First Name Last Name Phone * (###) ### #### Relation * * Contact Name: First Name Last Name Phone * (###) ### #### Relation * * Contact Name: First Name Last Name Phone * (###) ### #### Relation * Background Check * Have you ever been refused participation in any youth sport organization? Yes No If Yes, please explain. Have you ever been convicted of a felony? * Yes No Did the conviction deal with a minor? * Yes No N/a As a condition of volunteering, I give permission for WR to conduct a background check on me, which may include a review of sex offender registries, child abuse and criminal history records. I understand that, if appointed, my position is conditional upon WR receiving no information of inappropriateness in my background. I hereby release and agree to hold harmless from liability the WR officers, volunteers, and any other person or organization that may provide such information. I also understand that, regardless of previous appointments, WR is not obligated to appoint me to a volunteer position. If appointed, I understand that, prior to the expiration of my term, if I violate any WR policies or principles as outlined in the Coaches Conduct / bylaws, or undertake any activity that is deemed by the Board not to be in the best interest of our athletes or the organization programs, I will be subject to suspension and removal by the WR Baseball Board. * Please type your full name below to sign Date of Signature * MM DD YYYY Date of Birth * MM DD YYYY Place of Birth * Thank you!
