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Apopka Raptors 2017 Volunteer Application

* First Name:

* Last Name:

Prior/Maiden Names or Aliases:

* Current Address:

* City:

* State:

* Zip Code:

Home Phone:

Cell Number:

* Email Address:

Mailing Address (if different):

Date of Birth

* Month:

* Day:

* Year:

Occupation:

Employer:

Employeer's address:

Employeer's phone number:

Do you have children in the program?:

Yes

If Yes, what division and sport do they participate in?:

Please list any special professional training, skills, hobbies:

Community affiliations (clubs, service organizations, etc):

Previous/current volunteer experience:

Special Certification(s) (CPR, Medical, Police):

Yes

If Yes, please list the type of certification and the expiration date:

If No, would you be willing to be certified in CPR?:

* Have you ever been convicted of any crime involving or against a minor?:

Yes

* Have you ever plead guilty to, been convicted of or involved with any other type of crime?:

Yes

If Yes, please briefly explain:

* Have you ever been refused participation in any other youth program(s)?:

Yes

If Yes, please briefly explain:

In which of the following roles would you like to volunteer?:

Which level would you like to volunteer?:

Please List 3 references, aside from family members, at least one of which has knowledge of your participation as a volunteer in a youth program

* Reference #1 (Name, relationship to you, phone #):

* Reference #2 (Name, relationship to you, phone #):

* Reference #3 (Name, relationship to you, phone #):

Volunteer Confirmation of Information

I hereby swear and attest that all information provided on this application is true and complete to the fullest extent of my knowledge. If I am accepted as a volunteer, Apopka Raptors AAU, Inc. may end the relationship immediately if I have made any false statements or material misrepresentations, written or verbal. As a condition of volunteering, I hereby grant permission to Apopka Raptors AAU, Inc to conduct a background check on me, which may include a review of database records including but not limited to sex offender registries, child abuse and criminal history records in compliance with Central Florida Amatuer Athletic Union's child protection policy. I understand and agree 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 Apopka Raptors AAU Incorporated, the officers, employees, and volunteers thereof, and/or any other person or organization that may provide such information.

I also understand that, regardless of previous appointments, Apopka Raptors AAU, Inc. is not obligated to appoint me to a volunteer position. I understand that, prior to the expiration of my term, I am subject to suspension by the Board of Directors for any and all violations of Apopka Raptors AAU, Inc's policies or principles. Furthermore, I hereby attest that all contact information provided herein is up to date and I hereby grant Apopka Raptors AAU, Inc. and its partners permission to utilize such contact information for communications and promotions during my tenure as a volunteer.

NOTE: Apopka Raptors AAU, Inc.will not discriminate against any person on the basis of race, creed, color, national origin, marital status, gender, sexual orientation or disability.

I verify the information is true and complete to the fullest extend of my knowledge *

* indicates required fields

Apopka Raptors

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