Volunteer Form
Smithfield Packers Youth Sports
Smithfield Packers Youth Sports
Volunteer Form
Name
*
First Name
Last Name
Prior/Maiden Names or Aliases
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email
example@example.com
Date of Birth
*
-
Month
-
Day
Year
Date
Previous States Resided In The Past 5 Years (other than Virginia)
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Occupation
*
Employer
*
Employer Address
*
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Do You Have A Valid Driver's License?
*
Yes
No
Drivers License Number
*
Drivers License State
*
Please Upload A Copy Of A Valid Government-Issued Photo Identification
*
Browse Files
Drag and drop files here
Choose a file
Cancel
of
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Special Professional Training, Skills, or Hobbies
Community affiliations (Clubs, Service Organizations, etc.)
Special Certification (i.e. CPR, Medical, etc.)
Previous/Current Sports Volunteer Experience (and years)
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Child Participation
Do You Have Children In The Program
*
Yes
No
If Yes, At What Level Of Play
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Criminal Background
Have You Ever Been Charged With Or Convicted Of A Felony?
*
Yes
No
Felony: If Yes, Provide Your Current Legal Status (Parole, Etc.)
*
Have You Ever Been Convicted Of Any Crime Involving Or Against A Minor?
*
Yes
No
Crime/Minor: If Yes, Please Explain
*
Have You Ever Plead Guilty To/Been Convicted Of/Involved With Any Other Type Of Crime?
*
Yes
No
Other Type: If Yes, Please Explain
*
Have You Ever Been Refused Participation In Any Other Youth Programs?
*
Yes
No
Participation Refused: If Yes, Please Explain
*
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Position Selection(s)
Non-Sport(s)
Staff
Clean Up Team
Concessions Team
Equipment Team
Field Preparation Team
Fundraising Team
Scholastics Team
Social Media Team (Photography)
Social Media Team (Video)
Tutoring Team
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Position Selection(s)
Sport Team(s)
Basketball
Assistant Coach
Equipment Manager
Head Coach
Team Parent
Trainer
Cheerleading
Assistant Coach
Equipment Manager
Head Coach
Team Parent
Trainer
Football - Flag (06U CoEd)
Assistant Coach
Equipment Manager
Head Coach
Team Parent
Trainer
Football - Flag (Girls 12U [Ages 8-12])
Assistant Coach
Equipment Manager
Head Coach
Team Parent
Trainer
Football - Flag (Girls 17U [Ages 13-17])
Assistant Coach
Equipment Manager
Head Coach
Team Parent
Trainer
Football - Tackle (08U [Ages 7-8])
Assistant Coach
Equipment Manager
Head Coach
Team Parent
Trainer
Football - Tackle (10U [Ages 9-10])
Assistant Coach
Equipment Manager
Head Coach
Team Parent
Trainer
Football - Tackle (12U [Ages 11-12])
Assistant Coach
Equipment Manager
Head Coach
Team Parent
Trainer
Football - Tackle (14U [Ages 13-14])
Assistant Coach
Equipment Manager
Head Coach
Team Parent
Trainer
Track
Assistant Coach
Equipment Manager
Head Coach
Team Parent
Trainer
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References
Reference #1
*
First Name
Last Name
Nature Of Relationship To Reference #1
*
Phone Number Of Reference #1
*
Please enter a valid phone number.
Format: (000) 000-0000.
Reference #2
*
First Name
Last Name
Nature Of Relationship To Reference #2
*
Phone Number Of Reference #2
*
Please enter a valid phone number.
Format: (000) 000-0000.
Reference #3
*
First Name
Last Name
Nature Of Relationship To Reference #3
*
Phone Number Of Reference #3
*
Please enter a valid phone number.
Format: (000) 000-0000.
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Applicant Attestation
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, Smithfield Packers Youth Sports 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 Smithfield Packers Youth Sports 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 Smithfield Packers Youth Sports 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 Smithfield Packers Youth Sports, 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, Smithfield Packers Youth Sports 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 President and removal by the Board of Directors for any and all violations of Smithfield Packers Youth Sports policies or principles. Furthermore, I hereby attest that all contact information provided herein is up to date and I hereby grant Smithfield Packers Youth Sports and its partners permission to utilize such contact information for communications and promotions during my tenure as a volunteer. Binding Arbitration Policy: If appointed, I hereby understand and agree that any and all civil disputes by and between myself, Smithfield Packers Youth Sports, and any and all affiliated parties will be subject to binding arbitration in the locale of the Smithfield Packers Youth Sports in accordance with Virginia law under the guidelines and rules of the American Arbitration Association. I hereby agree that this binding arbitration shall be in lieu of any litigation by and between myself, Smithfield Packers Youth Sports and any and all affiliated parties. If any portion of this application shall be deemed unenforceable or invalid, this arbitration agreement shall still remain in full force and effect.
Confirmation Of Understanding
*
Yes
No
Applicant Signature
*
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