Coaching Application from Versailles-Woodford County Parks & Recreation Department

1. Versailles-Woodford County Parks and Recreation Youth Sports Coaching Application
275 Beasley Drive · Versailles, KY · (859) 873-5948 · www.vwcparksrec.com
Parks & Recreation youth sports coaches are required to complete a youth coaching application & submit to a background check annually. Coaches in competitive leagues (3rd grade and up) are must also complete a coaching certification course. If you are unable or unwilling to meet these requirements, you will not be permitted to coach.
LEAGUE:  Micro-Mites Cheer  Micro-Mites BKB  PeeWee Boys  JV Boys  Varsity Boys
 JV Cheerleading  Rookie BKB  PeeWee Girls  Varsity Girls  High School
GENERAL INFORMATION
Full Legal Name: Maiden:
Home Address: City: Zip:
Phone Numbers: (H) (C) (W)
E-Mail Address:
Would your work schedule conflict with practices or games, typically evenings and/or weekends?  Yes  No
NEW HEAD COACHES (COMPETITIVE LEAGUES ONLY)
Have you played basketball/cheered before?  Yes  No If so, what level(s)?
Have you coached basketball/cheerleading before?  Yes  No If so, what level(s)?
Have you coached for Parks & Recreation before?  Yes  No If so, what sport(s) & when?
Have you coached in any other youth leagues or organizations?  Yes  No If so, for what organization(s) & when?
Have you had any formal training as a coach?  Yes  No If so, please describe (i.e., PE degree, coaching courses, clinics, etc).
Have you ever been suspended or disciplined for behavior in a sports setting? If yes explain.
Describe your coaching philosophy.
What are the 3 most important concepts you would teach your players?
BACKGROUND CHECK REQUIREMENTS
Driver’s License #: Issue State of License: Birthdate:
Social Security #: Sex:  Male  Female Are you over 18 yrs old?  Yes  No
Have you ever been arrested or convicted of a crime?  Yes  No If yes, please explain:
· COMPLETE BOTH SIDES OF APPLICATION ·

2. I, ______________________________________________, offer to volunteer my services to the Versailles-Woodford County Parks and Recreation Department in the capacity of youth sports coach. I understand that I am working at all times on a voluntary basis and will not be paid in any way and that this agreement can be canceled at any time by the Department or by me.
I understand and agree that completing this application in no way guarantees that I will be granted a coaching position and that the Department assigns coaches as it sees fit.
I understand and agree that the Versailles-Woodford County Parks and Recreation Department will submit my name for a criminal background records check. I understand and agree that my final placement as a volunteer will be conditional upon a determination that I have not been arrested or convicted for any crime against children, crime of violence, sexual crime or any offense that would, in the judgment of the Parks and Recreation Department, make it inappropriate for me to have contact with children.
I hereby authorize the Versailles-Woodford County Parks and Recreation Department to receive any criminal history record informa- tion pertaining to myself which may be contained in the files of any state or local criminal justice agency.
I further agree that if I am assigned to a team that I will abide by the Department’s Zero Tolerance Policy, Coaches Code of Conduct and Physical and Verbal Altercation Policy. I understand that I am a representative of the Versailles-Woodford County Parks and Recreation Department and will conduct myself in such a way that reflects the vision and philosophy of the Versailles-Woodford County Parks and Recreation Department. I also understand that coaching youth sports is a privilege and not a right and that the Parks and Recreation Department has the right to remove me as a coach if it feels it is in the best interest of the players, league, and/ or Department.
I release the Versailles-Woodford County Parks and Recreation Department, it’s employees, agents, leaders, instructors, contractors and volunteers from any liability for loss or injury to myself or property which might occur due to negligence or other acts or omis- sions. This release applies to any losses or injuries which may occur as a result of, or during my participation in, volunteer service.
I realize that this is a binding contract. I have read and do understand it. I knowingly and voluntarily sign below. The Department may use my photograph for any official Departmental publications and/or productions.
Signature: Date:
Printed Name:
Volunteer Contract & Waiver of Liability
THE FOLLOWING FACTORS WILL DISQUALIFY AN INDIVIDUAL AS A VOLUNTEER:
If a Coach (1) has been convicted of, (2) has a charge pending against him or her in which it is alleged that he or she has committed any of the following crimes, or (3) has a record of a conviction of an equivalent offense, the Coach will be disqualified coaching or assistant coaching position for anytime Parks & Recreation Department team.
 All Sex Offenses – regardless of the amount of time since offense
 Any Felony Offense – regardless of amount of time since offense (In cases where a convicted felon has had his or her rights restored legally through the court system, the Parks & Recreation Board may, on a case-by-case basis, consider allowing said individual to serve as a youth sports coach. Considerations could include time since offense, type of offense and mitigating circumstances.
 All Crimes Against Children – regardless of the amount of time since offense
 All Misdemeanor Violence – within the past 10 years from time of arrest (must be no other disqualifying offenses within that 10 year timeframe)
 All Misdemeanor Drug & Alcohol Offenses – within the past 5 years, multiple offenses within the past 10 years or aggravating circumstance DUI in the past 10 years, from time of arrest.
 Any Other Misdemeanor – within the past 5 years from time of arrest, that would be considered a potential danger to children or is directly related to the functions of that volunteer.
 Open Charges – Persons with any open charges for disqualifying offenses shall be restricted from volunteering until the active case is brought to resolution or the charges are dropped.
NOTES:
This list of offenses is not intended to be all-inclusive of disqualifiers and does not set limits on the offenses that could disqualify any prospective volunteers. Department Staff and the Board of Directors has the discretion to permit or not permit an individual from volunteering in the role of coach or assistant coach as it deems appropriate, with the most important consideration always being what is best for the safety and well-being of the youth participating in its programs.
Any volunteer who is charged with and/or convicted of any of the above crimes during the course of the program is required to notify the Department. The volunteer should be immediately removed/requested to step aside from the volunteer position until such time that the Department head or its designee can (promptly) inquire into the circum- stances in order to reasonably determine whether the criminal offense (alleged or proven) creates a situation that could possibly signal danger to youth participants. It may be necessary that the volunteer be excluded from further involvement until the legal case is adjudicated; however, sufficient discretion should be afforded to the Department head, which should err on the side of caution and the best interests of the participating youth, to make an objective determination of the situation as quickly as possible. Volunteers should understand that their participation is appreciated and necessary to the success of the program, but must also understand that he/she necessarily has to be held to high standards and that the protection and well being of the youth participants is always paramount to the volunteer’s much appreciated desire to be involved. Failure on the part of a volunteer to notify the Department of arrests and /or convictions for any offense listed above will result in the volunteer being removed and declared ineligible to volunteer for any Parks & Recreation program or role for a minimum of five (5) years beginning on the date the failure to notify was discovered.