Junior Coach Registration Form

Junior Coach Registration
Junior Coach Information
Junior Coach Name*

First NameLast Name
Birth Date*

MonthDayYear
E-mail*
example@example.com
Emergency Information
Emergency Contact's Name*

First NameLast Name
Relationship
Phone Number*
Alt. Phone Number
What is your softball experience (years played, current role (player, umpire, none), etc)*
Why do you want to be a Junior Coach this year?*
Anything else we should know?
Are you applying to be a paid junior coach, or volunteer?*

PaidVolunteer
Have you completed your Foundations of Coaching Softball online modules?*

NoYes, FOCS 1Yes, Both FOCS 1 & 2
PARENTAL Informed Consent and Acknowledgement

I hereby give my approval for my child’s participation in any and all activities prepared by NWMSA during the Learn to Play sessions. In exchange for the acceptance of said child’s candidacy by NWMSA, I assume all risk and hazards incidental to the conduct of the activities, and release, absolve and hold harmless NWMSA and all its respective officers, agents, and representatives from any and all liability for injuries to said child arising out of traveling to, participating in, or returning from selected camp sessions.

In case of injury to said child, I hereby waive all claims against NWMSA including all coaches and affiliates, all participants, sponsoring agencies, advertisers, and, if applicable, owners and lessors of premises used to conduct the event. There is a risk of being injured that is inherent in all sports activities, including softball.
Confirmation

BY ACKNOWLEDGING AND SIGNING BELOW, I AM DELIVERING AN ELECTRONIC SIGNATURE THAT WILL HAVE THE SAME EFFECT AS AN ORIGINAL MANUAL PAPER SIGNATURE. THE ELECTRONIC SIGNATURE WILL BE EQUALLY AS BINDING AS AN ORIGINAL MANUAL PAPER SIGNATURE.
Date

MonthDayYear
Date
Parent/Guardian Signature

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Junior Coach Registration

Junior Coach Information