Revised 8.29.2017
Youth Athletic League Coaching Application
Thank you for your interest in volunteering with Raleigh Parks, Recreation and Cultural Resources Department. Please
complete the following application to serve as a volunteer coach with one of our Youth Athletic Leagues. A Parks, Recreation
and Cultural Resources staff member will contact you with more information on becoming a volunteer and completing a
background check.
Last First Middle Initial
City: State : Zip:
Phone (home): (cell):
Email: Birthdate: Age:
Would you like to subscribe to the Volunteer Services Program monthly newsletter? Yes No
Relationship: Phone:
Special Medical Circumstances:
Are you a returning coach? Yes No
Please select which coaching position you are applying to coach: Head Coach Assistant Coach
Please select which sport you are applying to coach:
Baseball Basketball Cheerleading Football Lacrosse Softball
Please select which age group you are applying to coach:
5-6 coed 7-8 coed 9-10 girls 9-10 boys 11-12 girls 11-12 boys
13-14 girls 13-14 boys 15up girls 15up boys other
Personal Information
Emergency Contact Information
Coaching Background
Revised 8.29.2017
Please select which District you would like to coach:
District 1 District 2 District 3 District 4 Citywide Any
Do you currently have youth participating in the athletic program?
If so, what is the player’s name and which league do they participate in?
Why would you like to coach?
What is your coaching experience?
Have you attended the National Alliance of Youth Sports (NAYS) training? Yes No
If yes, please list approximate date of training:
Circle select personal playing experience: Recreational High School College Pro
Do you currently coach or will you coach a private league or competitive travel team during the
same season for which you are applying to coach with Raleigh PRCR? Yes No
If yes, will this commitment allow you to give full participation and attention to coaching a Raleigh Parks
and Recreation team? Please explain your response:
What is your general coaching philosophy for coaching a recreational youth team?
Describe your coaching objectives for the season.
Revised 8.29.2017
THIS AGREEMENT, made this day of , , by and between
the City of Raleigh Parks, Recreation & Cultural Resources Department and the Citizen Volunteer,
WHEREAS, the city of Raleigh Parks, Recreation & Cultural Resources Department encourages public participation and
support in coaching youth athletic leagues; and
WHEREAS, the Citizen Volunteer has through past action and/or expressed interest to assist the City of Raleigh Parks,
Recreation & Cultural Resources Department with coaching youth athletic leagues; and
WHEREAS, both the Citizen Volunteer and the Department desire to establish a mutually beneficial relationship, hereby
enter into an agreement regarding their respective responsibilities for coaching a youth athletic team:
(Please initial each statement indicating that you are responsible for the following)
I agree that if I am selected to coach a team:
I will attend all coaches meetings or send a representative.
I will read, understand and abide by all league rules and the Raleigh Parks, Recreation and Cultural
Resources Department’s Youth Athletic Philosophy, Code of Conduct and Volunteer Services
Program Policy.
I will be responsible for the return of all equipment and coaches badges.
I will be responsible for my team’s and coach’s conduct on the field/court.
I will be responsible for my teams’ parents conduct during a game.
I will set a good example for the players and parents on my team.
I understand that associated with my volunteer coaching responsibilities with the Raleigh Parks, Recreation
and Cultural Resources Department, I may have the right to know certain personal and confidential
information regarding participants that I may work with. I agree to hold all information I may have access to
confidential and will not discuss or share any information to unauthorized parties. I also agree to provide only
information relevant to the specific service requested.
I understand that I am not authorized to take photographs/video of participants and/or staff without prior
approval from my league manager, for the sole use of the Raleigh Parks, Recreation and Cultural Resources
Department. I understand that if authorized to take photographs/video, I may not share or post the pictures
or information regarding any participant and/or staff.
By signing below, I acknowledge that I understand that sharing confidential information to unauthorized
parties may subject me to disciplinary action up to suspension and/or dismissal from my volunteer coaching
position with Raleigh Parks, Recreation and Cultural Resources.
Applicants Signature: Date:
Confidentiality Agreement
Coach’s Agreement
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Revised 8.29.2017
WHEREAS, the undersigned has requested to assist with coaching an athletic league at a facility within the
City of Raleigh, North Carolina; and
WHEREAS, the undersigned agrees to do so at his own risk and recognizing the possible and inherent danger
to his person or property resulting there from; and
WHEREAS, the City of Raleigh does not wish to be liable for any damages arising from personal injury or
property damage sustained thereby;
NOW, THEREFORE, In consideration of mutual promises and other good and valuable consideration, the
undersigned does hereby for himself and personal representatives:
A. Assume full responsibility for any personal injury or any damage to his property, which may occur,
directly or indirectly, in the course of coaching or assisting with athletic league programs.
B. Fully and forever release, and discharge the City of Raleigh, its agents and employees, from any
and all claims, demands, rights of action or cause of action, present or future, whether the same be
known, anticipated or unanticipated, resulting from or arising out of the above-described activity.
C. Agree that it is the intent of the undersigned that this Release and Indemnity Agreement shall be in
force and effect any time after the execution hereof.
The parties hereby agree by their signatures to the terms of this agreement as stated above. I certify that the
statements made in this Coaching Application are true, correct, and given voluntarily and information may be
disclosed to any party with legal and proper interest. I understand that I will not be paid for my services as a
volunteer, and I am giving my time freely to the Raleigh Parks, Recreation and Cultural Resources Department.
I understand that the Raleigh Parks, Recreation and Cultural Resources Department reserves the right to
screen volunteers, and the Department will not accept anyone as a volunteer who would jeopardize any aspect
of service or the safety of Parks, Recreation and Cultural Resources customers and staff.
Volunteer Name (Printed) Volunteer Signature Date
PRCR Youth Athletic League Manager Signature/Title* Date
Release and Indemnity Agreement
Supervisor Name: Phone:
Position of Volunteer: Volunteer Work Site:
PRCR Program, Site, or Facility:
Volunteer Duties:
% of Time volunteer unsupervised by FT PRCR staff:
% of Time volunteer in contact with minors:
*All volunteers who are approved must have the youth athletic league manager sign agreement above
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