EmailMe Form - Volunteer Coach Application

Thank you for volunteering to be an HRA Coach!

In order to provide HRA participants a safe environment and to protect the integrity of HRAs sports programs, HRA requires an application, background check, and three (3) personal references for all volunteer coaches. Please complete this form and submit as soon as possible. This form must be completed and submitted prior to the sport deadline in order for your request to coach can be considered.

Name: *

Address *

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region

Home Phone *

### - ### - ####

Work Phone

### - ### - ####

Cell Phone

### - ### - ####

Email *

List any previous youth sports you have coached or assisted (Sport, Date)

Coach position desired *

Sport you wish to coach *

Do you have any first aid or CPR training?

BACKGROUND CHECK - CONSENT & RELEASE

*All information will be kept CONFIDENTIAL*

For the protection of the children we serve, Highland Recreation Association requests the following information for all volunteer coaches working with children. Thank you for your help in providing the safest environment possible for our youth.

By completing this form, you give consent for Highland Recreation and/or its representatives to obtain the following information about you:
- Criminal Background Records,
- Personal Reference Verification

Please provide 3 personal references - please include phone number for each. *

Have you ever been convicted of a felony? *

If Yes, please indicate offense, date, & location, and any other information you feel necessary. (Please note, a conviction record will not necessarily disqualify you.)

Your Birthdate *

MM / DD / YYYY

Please provide any other important information about you that should be disclosed by you in regards to this application:

(Health conditions, etc)

I authorize information to be obtained either in writing or via telephone in connection with my volunteer application. Any person, firm or organization providing information or records in accordance with this authorization is released from any and all claims of liability for compliance. Such information will be held in confidence in accordance with HRAs guidelines. *

Please type your name to confirm your acceptance of this statement.

Coach Agreement

Please check the box below acknowledging your agreement to the following:

- I agree to abide by all HRA Rules and Codes of Conduct - PLEASE READ HRA Coach Codes of Conduct at http://www.highlandrecreation.org/codes-of-conduct.html

- I agree to promote good sportsmanship to my team and team parents.

- I will attend all practices and games; and if I am unable to attend, I will arrange to have another volunteer be there in my place.

- I will promptly communicate all practice times, game schedules, schedule changes, etc. to my team members.

- I will schedule practices on regular days/times and only change if absolutely necessary and acknowledge by all team members and their parents.

- I will return all sports equipment to HRA in a timely manner upon completion of the sport.

- I understand that I am not guarnateed a position as head or assistant coach and that all decisions regarding coaching positions are made exclusively by Highland Recreation Association.

- I understand that the Highland Recreation Association Board has the authority to dismiss me from coaching duties at any time if the Board deems necessary. Upon dismissal, I will be required to return all equipment promptly.

- I understand that misrepresentation or omission of pertinent facts on this application may be cause for immediate rejection.

*

I acknowledge and accept all above statements.

Please check the box above only if you agree to abide to all above statements and HRA's Coach Codes of Conduction. Any violation of the above or Codes of Conduct could subject you to HRA Board review up to possible dismissal.

HEAD COACH ONLY:

- It is my understanding that after the completion of my sport and return of the sport equipment, I will receive an HRA credit that can be used for a future HRA sports registration fee for my child. I also understand that if HRA determines that I have not fulfilled my duties and responsibilities assigned to me as coach, violated any of the above agreements, or if all equipment is not returned, that I will not receive the certificate.

I acknowledge and accept the above statement.