WYSE Volunteer Coach Form

WYSE Basketball Program

Volunteer Coaching Application Form

"Where Basketball Meets Growth and Development"

Section 1: Applicant Information

Full Name

Date of Birth

Date

Phone Number

Email Address

example@example.com

Address

City

State

Zip Code

Preferred Coaching Level (check all that apply):

Ages 6-8Ages 9-11Ages 12-14Ages 15-17

Availability daystimes

Section 2: Coaching Experience & Qualifications

Have you previously coached youth sports?

YesNo

If yes please describe your experience

Certifications (check all that apply): CPR / First Aid Certified (Attach copy) Concussion Training Certificate (AB 2007 compliant) Sudden Cardiac Arrest Prevention Training (AB 379 compliant) Youth Sports Coaching Certification (e.g., NFHS, PCA)

Basketball playingcoaching background optional

Section 3: California State Guidelines for Youth Sports Coaches

In accordance with California state law, all volunteer coaches must meet the following requirements before working with youth participants:

1. Live Scan Fingerprinting & Background Check: Required under California Penal Code Sections 11105.3 and 11105.07. All volunteers must clear a DOJ background check through fingerprinting (Live Scan

2. Concussion Training (AB 2007): Coaches must complete an online concussion and head injury training course (e.g., CDC Heads Up or NFHS Concussion in Sports) annually.

3. Sudden Cardiac Arrest Training (AB 379): Must complete a free online course to recognize and respond to signs of cardiac arrest in youth athletes.

4. Mandated Reporter Acknowledgment: As per California's Child Abuse and Neglect Reporting Act (CANRA), coaches may be considered mandated reporters and are encouraged to complete online training.

5. CPR & First Aid Certification: Strongly encouraged for all volunteer coaches and may be required based on age level coached.

Coaches must agree to uphold the WYSE Code of Conduct, demonstrating leadership, sportsmanship, and positive mentorship at all times.

Name

Phone Number

Relationship to You

Section 5: Consent & Acknowledgment

I hereby certify that the information provided is true and complete. I understand that my volunteer position is contingent upon meeting WYSE and California legal requirements, including fingerprinting, training, and background clearance. I agree to uphold the values of the WYSE Youth Basketball Program and follow all state laws and safety protocols to ensure a safe and positive experience for all youth participants.

Signature

Date

Training Certifications Verified

Date

Staff Initials