Page 1
COACH & VOLUNTEER ENROLLMENT APPLICATION
Please complete and return this form to:
Volunteer Coordinator, Parks and Recreation Department - City of Kannapolis
401 Laureate Way, Kannapolis, NC 28081
Email completed application to parks@kannapolisnc.gov
SECTION A PERSONAL INFORMATION
NAME _____________________________________________________________________________________________
FIRST MIDDLE LAST NAME I PREFER TO BE CALLED
OTHER INFO _____________________________________________________________________________________________
SOCIAL SECURITY NUMBER DRIVERS LICENSE # & ISSUING STATE DATE OF BIRTH
ADDRESS _____________________________________________________________________________________________
MAILING ADDRESS PHYSICAL ADDRESS (if different)
_____________________________________________________________________________________________
CITY STATE ZIP CODE
TELEPHONE _____________________________________________________________________________________________
MOBILE HOME WORK
EMAIL _____________________________________________________________________________________________
EMERGENCY CONTACT ______________________________________________________________________________________
FIRST & LAST NAME RELATIONSHIP PHONE NUMBER
SECTION B VOLUNTEER INTERESTS
VOLUNTEER POSITION APPLYING FOR ____________________________________________________________________________
I'D BE MOST INTERESTED IN....
Ongoing volunteer work - a regular Projects where I can work Other: ___________________________________
committment of 1 month or more. with a group.
Short term project or task that I can Projects I can complete at □ M □ T □ W □ Th □ F Sa □ Su
accomplish in a single day/week. home or remotely. □ Mornings □ Afternoons □ Evenings
AREAS OF INTEREST
□ Children □ Coaching □ Instructor □ Committee
□ Teens □ Baseball □ Special Events □ Other:_____________________
□ Adults □ Basketball □ Gardening & Landscaping
□ Families □ Football Marketing & Public Relations
□ Seniors □ Softball □ Office Administration/Receptionist
Page 2
WILL THIS FULFILL A SCHOOL REQUIREMENT OR WILL YOU RECEIVE SCHOOL CREDIT FOR YOUR SERVICE: □ Yes □ No
IF YES.... Is this a Service-Learning Experience? □ Yes □ No
_____________________________________________________________________________________________________
NAME OF SCHOOL NUMBER OF HOURS NEEDED DEADLINE
SECTION C BACKGROUND INVESTIGATION
If you are 16 years of age or older and want to serve in any volunteer capacity, you must undergo an annual background check (with
exception of serving on a board, commission, or at a special Event). For this purpose, a special event volunteer is defined as a
volunteer who is assisting with an event or project lasting less than one week. A copy of the Kannapolis Parks and Recreation
volunteer screening process is found in the Volunteer Services Orientation Manual. A signed Authorization for Release of Personal
Information for Employment/Volunteer Purposes is required.
SECTION D VOLUNTEER CONSENT AND WAIVER
I agree to conform to Kannapolis Parks and Recreation rules and procedures to the best of my ability and agree to respect the
confidential nature of information I may obtain as a volunteer for Kannapolis Parks and Recreation. I understand that a criminal
records check may be conducted. I also understand that Kannapolis Parks and Recreation reserves the right to discontinue the
services of any volunteer at any time.
I understand that I will not be paid for my services as a volunteer, and I am giving my time freely to the Kannapolis Parks and
Recreation Department. I also give my permission to use any photographs taken of me for marketing or other purposes.
I certify that the above statements are true, correct, and given voluntarily. In addition, I understand that this information may be
disclosed to any party with legal and proper interest.
__________________ _________________________________________________________
Date Signature of Volunteer Applicant
Parental Consent for Minor to Volunteer
In consideration of the City of Kannapolis, permitting my child to participate as a volunteer in the Parks and Recreation Department
and its associated activities, I acknowledge and agree to the following: (1) I represent that my child is in satisfactory physical and
mental health and physically/mentally able to engage in volunteer work and not be a danger to themselves or others. (2) I am aware
that as a parent of a minor that I will be held liable for any misconduct or behavior or unlawful activity that my child may engage in
while in a volunteer status with the City of Kannapolis.
__________________ _________________________________________________________
Date Signature of Parent/Guardian (if under 18)
If you are applying for a volutneer coaching opportunity, please continue to page 3 & 4.
Page 3
Office Use Only
Background Check______
ID Picture______
Approved Denied
Coach
Application
Coaching Position Applying For (check one) : Head Coach Assistant Coach
Sport: _______________________ Age Group: _______________________
1. Are you a new coach for The City of Kannapolis Parks and Recreation? YES / NO (circle one)
2. What day (Monday- Thursday) would be ideal for practice?
1
st
choice (circle) Monday Tuesday Wednesday Thursday
2
nd
choice (circle) Monday Tuesday Wednesday Thursday
3
rd
choice (circle) Monday Tuesday Wednesday Thursday
3. Shirt size: Adult Small □ Adult Medium □ Adult Large □ Adult XL □ Adult 2XL
4. Please describe your experience you have playing the sport that you are interested in coaching. ______________________
_____________________________________________________________________________________________________
5. Please list your coaching history (any sport).
SPORT YEARS EXPERIENCE
6. Please list three (3) refrences that can provide details regarding your character and/or coaching attributes.
NAME
PHONE NUMBER
EMAIL ADDRESS
7. Why are you interested in coaching for our program? _________________________________________________________
_____________________________________________________________________________________________________
8. Describe your personal philosophy towards youth sports. ______________________________________________________
_____________________________________________________________________________________________________
9. Will your child(ren) be playing in the league that you are interested in coaching? YES / NO (circle one)
a. If so, please list their name(s). _____________________________________________________________________
10. Please list the name of the person that you wish to coach with. (Only one head coach & one assistant coach per team)
_____________________________________________________________________________________________________
11. Please initial the following statements if you agree.
a. I agree to attend all meetings and workshops called by the City of Kannapolis and Recreation Athletic Staff. ______
b. I understand that failure to conduct myself in a sportsmanlike manner will result in dismissal from coaching. _____
Page 4
12. I agree to indemnify and hold harmless the City of Kannapolis, it’s officers, employees, and assigns from and against and all
claims damages, loses or expenses for personal injury, sickness, or loss, damage or destruction of personal property which
may arise out of or during my volunteer experience whether such claim be against me, for my benefit or otherwise. I
further understand and agree that volunteers are responsible for their own insurance coverage (medical, automotive,
liability, or any other type) and are not insured in any way by the City, and are not entitled to any type of benefits provided
to any employees of the City.
Coach’s Code of Conduct
1. I will do my best to insure that all participants have fun playing sports.
2. I will place the emotional and physical well being of my players ahead of a personal desire to win.
3. I will be knowledgeable in the rules of each sport that I coach.
4. I will, to the best of my ability, teach all participants the the rules and skills of the game, the values of teamwork, and the
meaning of good sportsmanship.
5. I will do my best to provide a safe playing situation for my players.
6. I will lead by example and demonstrate “good” sportsmanship before, during, and after the game.
7. I will assure that “all participants get the opportunity to play.”
8. I will communicate with the parents of the participants on my team and inform them of all team rules, practices, and
games.
9. I will remember that I am a youth sports coach, and that the game is for children and not adults.
10. I will report to City of Kannapolis Parks and Recreation staff any type of misconduct by observed coaches, players, parents
or officials, so that it may be dealt with appropriately.
PRINTED NAME SIGNATURE DATE
Chrome Web Store
It looks like you haven't installed the Fill Chrome Extension Add to Chrome