Coaching Application

Name *
Today's Date *
Today's Date
Address *
I'm interested in coaching: *
This information is required and will be used to run a background check.
Cell Phone *
Cell Phone
Business Phone *
Business Phone
Home Phone *
Home Phone
Date of Birth *
Date of Birth
Employer Address *
Employer Address
Do you have children in the program? *
Do you have a valid drivers license? *
Have you ever been convicted of or plead guilty to any crime(s) involving or against a minor? *
Are there any criminal charges pending against you regarding any crime(s) involving or against a minor? *
Have you ever been refused participation in any other youth programs? *
Which of the following would you like to participate? (Check one) *
Please list three references, at least one of which has knowledge of your participation as a volunteer in a youth program.
Reference One *
Reference One
Reference One Phone *
Reference One Phone
Reference Two *
Reference Two
Reference Two Phone *
Reference Two Phone
Reference Three *
Reference Three
Reference Three Phone *
Reference Three Phone
Condition of Terms
As a condition of volunteering, I give permission for the Little League organization to conduct background check(s) on me now and as long as I continue to be active with the organization, which may include a review of sex offender registries (some of which contain mane only searches which may result in a report being generated that may or may not be me), child abuse and criminal history records. I understand that, if appointed, my position is conditional upon the league receiving no inappropriate information on my background. I hereby release and agree to hold harmless from liability the local Little League, Little League Baseball, Incorporated, the officers, employees and volunteers thereof, or any other person or organization that may provide such information. I also understand that, regardless of previous appointments, Little League is not obligated to appoint me to a volunteer position. If appointed, I understand that, prior to the expiration of my term, I am subject to suspension by the President and removal by the Board of Directors for violation of Little League policies or principles.
Applicant Signature *
Applicant Signature
Date *
The local Little League and Little League Baseball, Incorporated will not discriminate against any person on the basis of race, creed, color, national origin, marital status, gender, sexual orientation or disability.