EmailMe Form - BOSS Internship Registration & Background Check

Date Time *

MM / DD / YYYY

Name *

First Last

Email

Phone

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

Address

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

Position applying for *

Which Season Are You Applying For *

Fall Winter - Semester (September - December) 2021

Winter / Spring Semester (January - April) 2022

Summer Semester (May - July) 2022

Fall Winter - Semester (September - December) 2022

Background Information

*These questions must be answered honestly, take your complete history into consideration. Any discrepancies will be grounds for disqualification.

Date of Birth *

MM / DD / YYYY

Number of years at present address *

Previous states you have lived in * *

1. Have you ever been convicted of, or pled “guilty” or “no contest” (“Nolo Contendere”) to, any crime, felony or misdemeanor?
(Note: answering yes will not necessarily result in disqualification)
If yes, what was the disposition? * *

Have you ever been involved with child abuse, child neglect or been convicted as a sexual predator?
If yes, explain * *

Have you ever had a problem with alcohol or drugs?
If yes, explain details * *

Internship / Volunteer Youth Coaching/Administration Contract
I understand that my responsibilities as a volunteer youth coach/administrator are of great importance and that my actions have the potential to significantly influence the youth whom I coach/teach/direct. Therefore, I promise to uphold the following rights of the youth of the program to the best of my ability. The right to:
- Participate in program fully
- Instill leadership and drive
- Receive qualified adult leadership
- Build positive characteristics in entrepreneurship
- Share in the leadership and decision-making of the program/subject matter for youth development
- Not encourage or share the use of illegal drugs or alcohol to minors
- An equal opportunity to strive for success
- Have fun in youth program/subject matter
- Seek to instill values of discipline, dedication and development within the programs curriculum

I also promise to conduct myself in accordance with the Code of Ethics for Coaches/Administration/Volunteers, etc...

I will:
 Treat each youth/player, opposing coach, official, parent and administrator with respect and dignity.
 Do my best to learn the fundamental skills, teaching and evaluation techniques, rules and strategies of the program.
 Become familiar with the objectives of the youth program with which I am coaching/assisting.
 Uphold the authority of the officials who are assigned to the program, and I will assist them, in every way, to conduct fair and impartial competitive games.
 Learn the strengths and weaknesses of the youth of the program so that I might place them into situations where they have a maximum opportunity to achieve success in practices and games/assignments while they improve their skill level.
 Protect the health and safety of the youth involved in the program.
 Adhere to all Best Of Student Shooters (B.O.S.S.) Youth League Fund, Inc. & Open Space policies and procedures.
 Notify staff if I will be absent or unable to attend functions due to emergency

With my signature, I acknowledge that I have read, understood, and will do my best to fulfill the promises made herein.

**I authorize the Best Of Student Shooters (B.O.S.S.) Youth League Fund, Inc. and the Background Information Systems Inc. to obtain, from any source, any information relevant to this application. I hereby authorize all sources to release such information to the Best Of Student Shooters (B.O.S.S.) Youth League Fund, Inc. Director. I hereby certify that the foregoing statements are true and correct and I agree that any misstatement or omission as to material fact will constitute grounds for unfavorable consideration of my application or dismissal from volunteering with the Best Of Student Shooters (B.O.S.S.) Youth league Fund, Inc. programs. (Please type or sign with your finger, cell phone pen, or mouse. Signature of your name will serve as your official signature) * *

Clear

Please type or sign with your finger, cell phone pen, or mouse.

BEST OF STUDENT SHOOTERS (B.O.S.S.)
YOUTH LEAGUE FUND INC.

Waiver/Release For Communicable Diseases Including COVID-19

WAIVER/RELEASE FOR COMMUNICABLE DISEASES INCLUDING COVID-19

ASSUMPTION OF RISK / WAIVER OF LIABILITY / INDEMNIFICATION AGREEMENT

In consideration of being allowed to participate on behalf of BEST OF STUDENT SHOOTERS (B.O.S.S.) YOUTH LEAGUE FUND INC. non profit program and related events and activities, the undersigned acknowledges, appreciates, and agrees that:

Participation includes possible exposure to and illness from infectious diseases including but not limited to MRSA, influenza, and COVID-19. While particular rules and personal discipline may reduce this risk, the risk of serious illness and death does exist; and,
I KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS, both known and unknown, EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASEES or others, and assume full responsibility for my participation; and,
I willingly agree to comply with the stated and customary terms and conditions for participation as regards protection against infectious diseases. If, however, I observe and any unusual or significant hazard during my presence or participation, I will remove myself from participation and bring such to the attention of the nearest official immediately; and,
I, for myself and on behalf of my heirs, assigns, personal representatives and next of kin, HEREBY RELEASE AND HOLD HARMLESS BEST OF STUDENT SHOOTERS (B.O.S.S.) YOUTH LEAGUE FUND INC. their officers, officials, agents, and/or employees, other participants, sponsoring agencies, sponsors, advertisers, and if applicable, owners and lessors of premises used to conduct the event (“RELEASEES”), WITH RESPECT TO ANY AND ALL ILLNESS, DISABILITY, DEATH, or loss or damage to person or property, WHETHER ARISING FROM THE NEGLIGENCE OF RELEASEES OR OTHERWISE, to the fullest extent permitted by law.
I HAVE READ THIS RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND SIGN IF FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT. *

BEST OF STUDENT SHOOTERS (B.O.S.S.)
YOUTH LEAGUE FUND INC.

CHAPERONE POLICY

Our commitment

We are committed to ensuring the safety and well-being of all young people involved in our program. The role of chaperone is part of that commitment. We are committed to providing the best possible support for chaperones and the young people they work with and have under their care and guidance. The chaperone also plays an important role in creating a positive team and program culture, in fostering cooperation and team spirit.

Purpose of Chaperones

To ensure that Field Trips for the students of Best Of Student Shooters (B.O.S.S.) Youth League Fund, Inc. are safe, educational, and enjoyable for all staff, coaches, volunteers, students, teachers, and chaperones. To assist the staff, coaches, volunteers , students, teachers, and chaperones in providing adequate supervision and ensuring the safety of all students. To assist the teacher in ensuring the educational objectives of the field trip are met.

Use of Chaperones

Best Of Student Shooters (B.O.S.S.) Youth League Fund, Inc. may appoint and use chaperones for events hosted by the non profit 501 c 3, tours and away trips when any of the youth involved are under 18 years of age. The chaperone to student ratio will be at least 1:8, one chaperone for every eight students under the age of 18. Chaperones will be appointed for all away trips that include at least one overnight stay.

Scope

This policy applies to anyone, whether they are in a paid or voluntary capacity, that is appointed as a chaperone for Best Of Student Shooters (B.O.S.S.) Youth League Fund, Inc.. This policy will continue to apply to a person even after they have stopped their association or employment with Best Of Student Shooters (B.O.S.S.) Youth League Fund, Inc. if disciplinary action, related to their role as chaperone, has commenced.

Responsibilities

The chaperone’s role varies from one team or event to the next. The final list of responsibilities will be determined by the coach or manager, depending on the age of the athletes, the nature of the event and the skills and qualifications of other accompanying adults

• While field trips should be fun, the educational value and safety of the students is our priority.
The field trip is an extension of the classroom. To maximize student learning and group participation, we kindly discourage non-chaperones from attending or being present at the field trip destination.

• If necessitated by the specific venue, Chaperone count may need to be limited.

• Parents will be able to accompany their student to at least (1) one of the scheduled field trips during the program semester. Staff will notify all parents of the scheduled dates of field trips throughout the year.

• Chaperones must be a parent/guardian or grandparent of a student in the class for which they are volunteering.

• Siblings or other non-students are not allowed to accompany Chaperones, due to safety and space considerations.

• Parents/guardians must have completed background check on file prior to volunteering to be a chaperone.

• Chaperones will be paired up and assigned to a group of students so that there are always at least two approved chaperones present with students. Chaperones will not be left alone with any student(s) other than their own child.

• Students requiring medication during field trips will be assigned to a volunteer or Best Of Student Shooters (B.O.S.S.) Youth League Fund, Inc. staff member. Chaperones are not permitted to dispense, handle or carry medication for any student other than their own child. Teacher/staff will carry/dispense medication.

• If determined necessary by Best Of Student Shooters (B.O.S.S.) Youth League Fund, Inc. Staff, parents of children with special medical or behavioral needs may be exempt from the chaperone number limit. This will be evaluated on a case by case basis, and must be approved in advance.

• Chaperones will receive, in advance, an email detailing specific procedures for the field trip. Chaperones will be required to review the email thoroughly and reply confirming that they have read and agree to abide by all schedules, rules, procedures, etc.

Information contained in this email will include but not be limited to:

o Names of each student and additional chaperone(s) assigned to their group, including cell phone number of the other chaperone assigned to their group.

o Detailed schedule of the day’s itinerary with specific times and locations for group meeting places, group activities, designated lunch time & place, etc.

o Information on field trip logistics for the specific venue (ex: youth stay together or divide by chaperone groups)

o Venue specific learning objectives (if applicable)

o Phone number for Best Of Student Shooters (B.O.S.S.) Youth League Fund, Inc.staff member present during field trip

• Any student behavior issue should immediately be referred to
the Best Of Student Shooters (B.O.S.S.) Youth League Fund, Inc. for appropriate handling.

Chaperones are expected to speak and act in a responsible manner at all times while on the trip.

Chaperones are expected to maintain discipline at all times during the trip, which includes, but is not limited to the following:

1. Ensure that students are in assigned seats.
2. Ensure that no stereos or electronic games without headphones are being used during travel that could result in a distraction or disturbance.
3. Ensure that students are quiet and courteous on the transportation vehicle and in the hotels/motels.
4. The responsibilities for assigning consequences, or using physical restraint, rest with the staff or trip supervisor. Report any major and/or continued infractions to the teacher as soon as possible.

Lead Coordinators of the trip should be notified immediately of any disciplinary issues.

Refer any serious behavioral problems(s) immediately to the trip's sponsor. If serious infractions occur, an administrator will be contacted to determine if the student needs to be sent home.
The student's parents will be notified and students will be sent home.
The cost of transportation for the student and chaperone will be the responsibility of the parent.
Infractions include, but are not limited to, members of the opposite sex in each other's room; possession of controlled substances or alcohol; theft; vandalism; or leaving the trip or any supervised area without permission.
In addition, disciplinary action will apply including the protocol regarding the contact and involvement of local law enforcement authorities.

A chaperone accompanying a team or group of athletes will be required to:

 ensure the schedule is followed, for example, curfews, meal times, sessions; Be on time for designated meeting places and departure.

 make sure athletes have any clothing or equipment they need for competition or training, for example, the right uniform or strip and relevant accreditations;

 organise and prepare any “in house” meals and supervise members involvement in meal preparation and clean up;

 enforce the rules and report any infraction

 handle any emergencies with common sense and according to our codes and guidelines.

Chaperones need to familiarise themselves with appropriate policies and practices;

 accompany an injured or ill athlete who needs medical attention;

 make sure other relevant important issues are adhered to, for example, Dropping Off and Collection of Children.

 work cooperatively with team officials, including coaches and managers;

 help supervise travel schedules and travel logistics;

 not consume any alcoholic beverages or drugs whilst on chaperone duty;

 safeguard the athlete’s tickets, keys, valuables and money when appropriate;

 maintain a contact list of key people, such as managers, coaches, parents, emergency.

 Attendance will be taken prior to leaving campus and must be reported to Lead Coordinators in arriving and leaving events.

 Hotel Stays - If students are staying at a hotel, bed checks are required nightly and each morning by adult chaperones with reasonable curfews including "lights out" times established and enforced. When room assignments are issued there will be no room switching. No boys in girls’ rooms and vice versa at any time. Any student found to be in violation will be referred for disciplinary action.

Adults shall not be in a state of undress with students under any circumstances

Selection criteria

Any person being considered for appointment to the role of Chaperone must:

 be over the age of 18;

 have completed a Background / Working with Children Check;

 possess a current driver’s license;

 provide a brief written overview of any relevant experience;

 have a current first aid certificate (desirable);

 provide details for two references who can attest to the applicant’s suitability to the role.

If you have questions about any aspect of the field trip or the expectations of chaperones, please ask for assistance from the staff member in charge. We hope you enjoy your field trip experience. I have read, understand, and agree to comply with the guidelines

I have read, understand and will follow the guidelines and expectations if I am selected to be a field trip chaperone concerning information llisted above as well as those outlined by Best Of Student Shooters (B.O.S.S.) Youth League Fund, Inc.

Sign (Print Name) *

Background Information *These questions must be answered honestly, take your complete history into consideration. Any discrepancies will be grounds for disqualification.

Background Information

*These questions must be answered honestly, take your complete history into consideration. Any discrepancies will be grounds for disqualification.