Upward Basketball Coach Application by vow85608

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									                        Upward Basketball Coach Application
Name: ___________________________________________________________________________________
Email Address: _____________________________________________________________________________
Phone Number: ___________________________________________________________________________
Mailing Address: ___________________________________________________________________________
Date of Birth: ______________________ _________Gender: _______________________________________
Are you a member of a local church? Yes            No         Where: ___________________________________

1. Circle the group you prefer to coach: Grade 1-2             Grade 3-4         Grade 5-6         Boys     Girls
2. Have you reviewed the practice and game schedule and can commit to those dates? Yes                    No
3. Circle your preferred practice time on Sundays:        2pm     3pm      4pm     5pm       6pm    7pm
4. Circle your shirt size: X-Small      Small    Medium       Large     X-Large    XX-Large        XXX-Large
5. Please list your children who will be playing or cheerleading in this year’s Upward League, if applicable.
Child Name                       Grade      Gender            Sport                 I plan to coach my child’s team
_________________________         ____       M F       basketball cheerleading                 yes no
_________________________         ____       M F       basketball cheerleading                 yes no
_________________________         ____       M F       basketball cheerleading                 yes no
6. Please share a little about your relationship with the Lord and your spiritual beliefs.
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________

7. Please list anyone else you think might be interested in coaching. (Include their email or phone number)

__________________________________________________________________________________________________

8. I will be able to attend the Coach Training Conference on November 1, 2:00-4:00 pm at PazNaz. Yes           No


I understand that any negative personal habits that I have (smoking, alcohol, profanity, etc.) may have a negative
effect on a child’s spiritual development. Understanding that the children on my team have been placed under my
guidance, I commit to setting a worthy behavioral example for the m to look to.

Coach Signature: ______________________________________________________ Date: ________________________

								
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