Upward @ Park Chapel

Coach & Referee Information & Application

Coaches and Referees are very important to the success of Upward! If you are interested in coaching or officiating please fill out the application below. Upon receiving your application we will process it and contact you with appropriate details.

Please note, we take the safety of children very seriously. Therefore, all coaches (chearleading and basketball) will be required to pass a criminal background check prior to the start of the season. Upon completion of the online coaching application, you will receive instructions concerning the background check release form.

By completing this application you agree and understand that any negative personal habits (smoking, alcohol, profanity, etc) may have a negative affect on a child’s spiritual development. Understanding that the children on your team have been placed under your guidance, you commit to setting a worthy behavioral example for them to look to.

Choose all that apply	I would like to coach girls I would like to coach boys I would like to referee
Name (first, last)
Mailing Address
City, State, Zipcode
Phone Number
Email
Are you a member of a local church?	Yes No
If yes, where?
Gender
Date of Birth (xx/xx/xxxx)
Preference
Division
Let us know the names of your children particitpating and if you would like to coach their team
I prefer to practice on	Mondays Tuesdays Thursdays
I prefer to practice at
Which evaluation(s) will you attend?	Monday November 16 between 6 - 8pm Tuesday November 17 between 6 - 8pm Saturday November 21 between 10am - 12pm
Shirt Size (sizes are gender specific)
Have you coached Upward Basketball before?	Yes No
Have you refereed Upward Basketball before?	Yes No
Have you made a personal commitment to Jesus Christ?	Yes No
Please tell us a little about your relationship with Jesus
Any other information you would like to include