Litchfield Park Little League - (Litchfield Park, AZ)

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Manager/Coach Application

* Name:

* Address:

* City:

Zip Code:

* Phone Number:

* Drivers License Number:

* State:

* Email:

Ever Convicted of:

Drug Possesion:

DUI/DWI

Immoral Act

Sexual Abuse

Child Abuse

Are you willing to be fingerprinted & authorize a limited criminal background check?:

* Will you have a child in the program:

Name(s), Age(s), & Division(s) of Children:

Do you desire to be:

Manager

Coach

Which Division:

Did you manage/coach a Litchfield Park Little League team in 2014?:

Which Division?:

* Why do you wish to manage/coach?:

* Brief description of experience::

* How would you define a successful team?:

* Outline a practice schedule::

List 3 References (1 Personal Reference & 2 Youth sports references Preferred)

* 1. Name:

* 1. Phone Number:

1. Relationship:

* 2. Name:

* 2. Phone Nubmer:

2. Relationship:

* 3. Name:

* 3. Phone Number:

3. Relationship:

I understand that as a Manager/Coach, I represent a very responsible and trusted position in the League. As an adult volunteer, I am required to abide by the rules of Little League Inc. and operating procedures and by-laws of Litchfield Park Little League. I am responsible for all property of the League including equipment and uniforms issued to me and will return all as requested at the end of the season.

I understand that in the role of Manager/Coach my actions directly influence the physical, mental and emotional development of youngsters participating in the program. I promise to conduct myself in a manner which is a positive influence on all players; and agree not to discriminate against any player based on ability, race, or otherwise. I will attend all mandatory Certification and Training Clinics, Field Days and other events as directed by the Chief Player Agent or Board of Directors; if called upon, I will Umpire games to support the program.

I HEREBY CERTIFY THAT I HAVE READ, UNDERSTOOD AND AGREE TO THE AFOREMENTIONED STATEMENT, AND THAT THE INFORMATION DISCLOSED ON THIS FORM IS TRUE & CORRECT. I AUTHORIZE VERIFICATION OF ANY INFORMATION DEEMED NECESSARY BY THE BOARD OF DIRECTORS.

Read and Agree to Above *

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