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VOLUNTEER Background Check Authorization 800 Goodnight Ave Pueblo, CO 81005 (719) 553-2790 www.puebloparks.us We appreciate your interest in volunteering for our community. In order to insure that we select the most qualified volunteers for our programs AND to insure the safety of our children participating in these programs, we request that you complete all sections of this volunteer application. Full Name (First, MI, Last): Home Telephone Number: Email address ( ) Cellular Number: ( ) Street Address: City, State, Zip Code Social Security Number: Birth Date (Mo/Day/Yr): Have you ever been known by another name? YES NO If YES, indicate below: For volunteer coaching, please list sport and age group/grade applying for coaching status: V O L U N T E E R E X P E R I E N C E List all experience working with youth including dates, age groups, sports coached or officiated and certification. B A C K G R O U N D Have you ever been charged with a crime that resulted in plea of guilty, no contest, deferred judgment, deferred prosecution or conviction of any law violation (except minor traffic violations)? YES NO If YES, please list each conviction: (1) date of offense; (2) charge; (3) jurisdiction; (4) court name and (5) disposition. Have you ever been involved in an incident involving child abuse or child neglect? YES NO If YES, please explain below: Signature, Certification, Release of Information, and Release of Liability I certify that the information in this application is true and complete. I understand that false statements, misrepresentations or omissions of information in this application may result in rejection of this application. The City is expressly authorized to investigate all statements contained in this application. I consent to the release of information about my ability and fitness for volunteer coaching assignment by employers, schools, law enforcement agencies, and other individuals and organizations to investigators, personnel staffing specialists and other authorized employees of the City of Pueblo. I authorize the City of Pueblo to obtain CCIC/NCIC information regarding my background. In the event that I am selected to become a volunteer for the City of Pueblo, I agree to comply with all of its ordinances, rules, and regulations. I fully understand and agree to provide my services to the City of Pueblo in a voluntary capacity and that I will receive no compensation or benefits for services provided. I understand that I am NOT insured by the City’s Worker’s Compensation Insurance. I authorize that all necessary first aid steps may be taken as prescribed by qualified personnel. I hereby release the City of Pueblo, its officers, employees and agents from any and all claims, damages, cost or expense including attorney fees, and liability, including any claims of personal injury and property damage arising from my participation as a volunteer with the City of Pueblo. I grant full permission to use any photographs, videotapes, recording or any other record of this program for any purpose. By signing below, I agree that I understand and consent to the above statement: Volunteer signature: Date: If volunteer is under 18, signature of parent or guardian: Date: FOR CITY USE ONLY Reviewed by: _______________________________________________________ Comments: ________________________________________________________ Police background: Sex-Offender Registry: Fingerprint Check: VOLUNTEER YOUTH COACHING CONTRACT I understand that my responsibilities as a volunteer youth coach are of great importance and that my actions have the potential to significantly influence the young athletes whom I coach. Therefore, I promise to uphold the following RIGHTS OF THE YOUNG ATHLETE to the best of my ability. 1. The right to participate in sports. 2. The right to participate at a level appropriate to each child’s maturity and ability level. 3. The right to receive qualified adult leadership. 4. The right to play as a child and not as an adult. 5. The right to share in the leadership and decision-making of their sport. 6. The right to participate in a safe and healthy environment. 7. The right to proper preparation for participation in sports. 8. The right to an equal opportunity to strive for success. 9. The right to be treated with dignity. 10. THE RIGHT TO HAVE FUN IN SPORTS! I also promise to conduct myself in accordance with the CODE OF ETHICS for Coaches as given below: 1. I will treat each player, opposing coach, official, parent and administrator with respect and dignity. 2. I will do my best to learn the fundamental skills, teaching and evaluation techniques, and strategies of my sport. 3. I will become thoroughly familiar with the rules of my sport and teach these rules to my players. 4. I will become familiar with the objectives of the youth sports program with which I am affiliated. And I will strive to achieve these objectives and communicate them to my players and their parents. 5. I will uphold the authority of the officials who are assigned to my sport, and I will assist them in every way to conduct fair and impartial games. 6. I will learn the strengths and weaknesses of my players so that I might place them into situations where they have a maximum opportunity to achieve success. 7. I will conduct my practices and games so all players have an opportunity to improve their skills through active participation. 8. I will communicate to my players and their parents the rights and responsibilities of individuals on our team. 9. I will lead by example in demonstrating fair play and sportsmanship to all my players, officials, and spectators. 10. I will protect the health and safety of my players by insisting that all the activities under my control are conducted for their psychological welfare rather than for the vicarious interests of adults. 11. I will adhere to all Pueblo Parks & Recreation Department Youth Sports Division policies and procedures. With my signature, which I voluntarily affix to this contract, I acknowledge that I have read, understand and will do my best to fulfill the promises made herein. Sport Name of Coach (PLEASE PRINT) Date Signature of Coach ______ __________________________ Please Specify (Head Coach/Assistant Coach) Signature of Sports Coordinator Pueblo Parks & Recreation Youth Sports Division Youth Sports Coaching Certification Clinic Study Guide The Mission of the Pueblo Parks & Recreation Youth Sports Division is to enhance the quality of life for all citizens of Pueblo, by providing a comprehensive selection of athletic opportunities, programs and experiences; encouraging participation and involvement in athletic opportunities, programs and experiences through outreach, training and marketing; and providing programs that are well-designed, accessible and safe. The purpose of the On-line Youth Coaching Certification Clinic is to offer coaches the essential information they need to coach children between the ages of 5 and 17. Youth sport coaches have tremendous responsibility to provide a fun, safe environment that helps their athletes learn skills and strategies. The Youth Coaching Clinic introduces potential coaches (and reinforces with veteran coaches) the importance of the following key concepts: • Coaches – Communication, Preparation & Safety • Coaches Guidelines • Why do Kids Play Sports and why do They Quit? • Maintaining Positive Perspective • Primary Responsibilities of a Coach • Coaches Code of Ethics • Athletes First; Winning Second • Coaching With Character • Communicating with Parents • Keys to Becoming a Successful Coach • Managing Risks and Creating a Safe Environment • Coaching Aides – Practice Plans • PLAN B Potential coaches should read through all of the included coach clinic info/concepts. After reading the training materials, please read the Coach Certification Test Instructions, and follow the directions. Certification Clinic training materials can be very useful to parents as well. Coaches Welcome to the Pueblo Parks & Recreation Youth Sports Division! The role of a youth sports coach can be very rewarding. In Youth Sports, we are striving to provide a positive, supportive environment in which the children can improve on their skills and participate on a team that nurtures positive peer interaction and fun. The primary goal of this program is our commitment to all participants rather than producing an atmosphere of excellence for a talented few. To win at all costs may be the primary goal for professionals, but this is contrary to the basic philosophy of the Pueblo Parks & Recreation Youth Sports Division. With this in mind, no individual or team record is kept. Coaching in a youth sports program is teaching – teaching values, ethics, sportsmanship and skills. Try to incorporate all of these aspects into your interactions with your team members. Show your team the path to good sportsmanship. In coaching youth sports for Pueblo Parks & Recreation, the objective is to provide organized, quality practices through communication, preparation and safety. It is absolutely essential that you communicate initially and quite regularly with parents/guardians and your team members. It is imperative that your players and their parents/guardians know your name and phone number in case of any emergency. Be prepared for the task at hand, whether it is practicing or getting ready for the game. Being prepared encompasses a wide variety of fundamental issues such as practice organization, proper equipment, knowledge of rules and program philosophy as well as attendance at staff meetings and clinics. A thorough knowledge and understanding of good safety procedures will save a lot of time. Horse play, climbing fences or using faulty equipment are troublesome danger areas. These kinds of things are often overlooked, yet often take time away from actual practice or game time. You need to constantly be aware of safety needs. As a coach, it is your job to help the players feel good about themselves, not to criticize or demean them. If a player makes a mistake, remain positive while encouraging them to do their best and work to improve their skills.

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