YOUTH SPORTS COACH APPLICATION
(To be completed by any individual working with program participants.)
The City of Grove City Parks & Recreation Department
614-277-3050 Rain Line: 614-277-3060 Kingston Center, 3226 Kingston Ave., Grove City, OH 43123
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PERSONAL INFORMATION
LAST NAME FIRST NAME MI
HOME ADDRESS CITY STATE ZIP
PREVIOUS ADDRESS IF AT ABOVE LESS THAN 5 YEARS CITY STATE ZIP
DAYTIME PHONE CELL/OTHER PHONE EMAIL
DATE OF BIRTH SOCIAL SECURITY NUMBER GENDER
Male Female
TSHIRT SIZE
M L XL 2XL Other:
SPORT COACHING LEVEL
Baseball Basketball Volleyball Head Coach Assistant Coach Either
GENERAL QUESTIONS
Why are you volunteering for this position?
What experience do you have working with children?
List any formal training you have that relates to coaching children:
I agree to abide by the Coaches Code of Conduct, any other written rules and the spirit of the City of Grove City Parks and Recreation
Department that all programs are for the sole benet of the children participating.
I agree to complete any necessary training including state-mandated concussion training (oered free online).
I understand that I serve at the discretion of the City of Grove City Parks and Recreation Department and am under the direct supervision
of the sports supervisor or other designee. I further agree to abide by the decisions made by the sports supervisor or other designee
not specically covered by the information furnished in the volunteer application.
The above information is true and complete to the best of my knowledge. I understand that the City of Grove City may investigate the
information I have furnished and I realize that any misrepresentation or false information in the application may lead to termination of
any volunteer services to the City. I consent that the City of Grove City may conduct a background check.
COACHING APPLICANT SIGNATURE DATE
PRESENT EMPLOYER DATE EMPLOYMENT BEGAN
ADDRESS CITY STATE ZIP
POSITION SUPERVISOR’S NAME
I AM COACHING MY CHILDS TEAM LEAGUE CHOICE
No Yes CHILD’S NAME:
COACH’S CODE OF CONDUCT
Coaches shall remain unconditionally supportive of the organizations commitment to the ideals of good sportsmanship, team play,
honesty, loyalty, courage and respect for authority. Likewise, coaches shall remain sensitive to the physical and emotional well-being
of the players on his/her team.
As a coach, I shall:
Be a positive role model.
Display and instill in my players the principals of good sportsmanship and team play.
Conduct myself in a manner that best serves the interests of the players on my team and others.
Do my best to provide a positive experience for all players.
Ensure that my team will win and lose in a manner that exhibits respect and good sportsmanship.
Treat all players, parents, spectators and league ocials with respect.
Provide instruction in a manner that is constructive and supportive.
Not ridicule or demean players on my own or other teams, ocials, parents or other program participants.
Not tolerate behavior that endangers the health or well-being of a child.
Complete all appropriate training including concussion recognition education.
Comply with the decisions of league ocials and observe all rules, policy and procedure as established or endorsed by
Grove City Parks and Recreation (GCPR).
Teach the sport to the best of my ability.
Be drug and alcohol free while at any GCPR athletic event.
Not use tobacco products at any time during a GCPR activity.
Acknowledge the need to demonstrate fundamental prociency with respect to the game.
Grove City Parks and Recreation has a zero-tolerance policy, the violation of which could result in an indenite suspension up to a
lifetime ban from Parks and Recreation activities. This includes, but is not limited to:
ghting physical contact aggressive behavior towards an individual
profanity belittlement of players violation of the substitution rule.
Anyone who fails to conform their conduct to the preceding code of conduct while attending, coaching, ociating or participating
in a youth sports event will be subject to disciplinary action, including but not limited to the following in any order or combination:
y If an individual is ejected from a game for any reason, that individual must leave the facility, is immediately suspended and
will not be permitted at any future practices or games until the sports supervisor or a designee has reviewed the incident.
y The individual ejected, witnesses and the ocial must submit an incident report explaining the situation that resulted in
the ejection.
y Based upon the information provided, the suspension may result in a minimum of a one game suspension up to permanent
removal from all future league activities conducted by Grove City Parks and Recreation.
y If an individual is ejected from two separate games, that individual will be immediately removed from the league without
a refund and will not be permitted at any facility for games for the remainder of the season.
I agree that youth sports programs play an important role in promoting the physical, social and emotional development of
children. Therefore, it is essential for parents, coaches, spectators and ocials involved in youth sports events to model good
sportsmanship and lead by example by demonstrating fairness, respect and self-control.
I accept any penalties that are assessed to me relating to my behavior.
COACHING APPLICANT SIGNATURE DATE
The City of Grove City Parks & Recreation Department
614-277-3050 Rain Line: 614-277-3060 Kingston Center, 3226 Kingston Ave., Grove City, OH 43123
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