Coaching Renewal Form

First Name*

Last Name*

Email used for your online profile:*

example@example.com

Membership Serial Number*

Your 8-digit membership number can be found in the lower-left corner of your membership card. A valid membership is required to hold a coaching license.

Membership Expiration Date*

Phone Number*

Please enter a valid phone number.

Date of Birth*

Must be 18 years or older.

Street Address*

Street Address Line 2*

City *

US State

Canadian Province

Zip Code*

Country*

Please name your home track.*

During the last year, did you host regularly scheduled beginner clinics?*

Is your online profile with USA BMX up to date with a profile picture and a bio of yourself as a coach?*

Does your track use the free website provided by USA BMX?*

This is frequently referred to as the "microsite".

Does your track (or you) charge for clinics? If so, how much?*

What methods did you employ to create a commitment of attendance for new riders? (How do you get them to really commit to coming back each week?)*

Do you know if your background check is currently up to date? They must be renewed every two (2) years.*

Do you know if your adult and pediatric CPR and basic first aid certifications are current?*

Are you aware that if a clinic is held on a day that no other scheduled race or practice is held that it must be reported on a TORF form as a practice and submitted to USA BMX for insurance purposes? *

Name*

First NameLast Name

Mailing Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Please read each statement and check the box to agree with each statement:

I understand that I have to submit my background check to USA BMX every two years and will be notified if I am required to do so.I understand that I must submit a copy of a valid Adult and Pediatric CPR Certification.I understand that if I complete an online CPR certification, I must also complete an in-person training to be fully certified.I understand that I must complete the Abuse Prevention Systems Sexual Abuse Awareness Training program every two years.I understand that all coaches are required to have an active USA BMX Membership License.I understand that I will not receive my coaching certification until the all of the license requirements have been verified by the Coaching department.I understand my coaching license will now expire when your membership expires and I will have to submit a coaching renewal application to reactivate my license.I understand that as a coach my actions will reflect on my local track and I will maintain a professional presence at the track at all time.

Signature*