Palos Verdes-Volunteer Application

Application Type*

CAL Waiver*

In which of the following roles would you like to volunteer?*

Have you completed an SCC live scan (Background Check)?*

Badge Photo (DO NOT USE YOUR State Issue ID PHOTO) Headshots only*

This is for an ID Badge.

Legal Name*

First NameLast Name

ID Upload*

Prior/Maiden Names or Aliases:

Birth Date*

Date

Mailing Address:*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Current home zip code:*

Previous states resided in in the past 5 years:*

Phone Number:*

Please enter a valid phone number.

Email:*

example@example.com

Employer:*

Occupation: *

Employer Address:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Do you have a valid driver’s license?*

Driver’s License No.:

Driver’s License State:

Special professional training, skills, hobbies:

Community affiliations (clubs, service organizations, etc.):

Previous/current volunteer experience (e.g. baseball/softball and years):

Special certifications (i.e. CPR, medical, etc.):*

Do you have children? *

If YES, are they currently participating in Pop Warner?*

If applicable, what age levels are your children in Pop Warner?*

Have you ever been charged or convicted of a felony?*

If yes, provide your current legal status (parole, does not apply, etc.):*

Have you ever been convicted of any crime involving or against a minor?*

Have you ever plead guilty to, been convicted of or involved with any other type of crime?*

If yes, provide your current legal status (Fine, does not apply, etc.):*

Have you ever been refused participation in any other youth programs?*

If YES, explain: *

Reference 1*

First NameLast Name

Reference 1 Phone*

Please enter a valid phone number.

Reference 2*

First NameLast Name

Reference 2 Phone*

Please enter a valid phone number.

Reference 3*

First NameLast Name

Reference 3 Phone*

Please enter a valid phone number.

I hereby attest that all information provided on this application is true and complete. If I am accepted as a volunteer, PopWarner may end the relationship immediately if I have made any false statements or material misrepresentations. As acondition of volunteering, I hereby grant permission for Pop Warner to conduct a background check on me, which may includea review of database records including but not limited to sex offender registries, child abuse and criminal history records, incompliance with Pop Warner's 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 Pop Warner Little Scholars, Incorporated, its affiliated leagues and associations, 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, Pop Warner 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 Pop Warner policies or principles. Furthermore, I hereby attest that all contact information provided herein is up to date and I hereby grant Pop Warner Little Scholars. Inc. 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, Pop Warner and any and all affiliated parties will be subject to binding arbitration in the locale of the Pop Warner Little
Scholars, Inc. National Office in Langhorne, PA in accordance with Pennsylvania 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, Pop Warner 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.

Members Code of Conduct
In addition to the General Code of Conduct, all Pop Warner coaches, administrators and other program volunteers shall:

Create a positive, safe and healthy environment, free of abuse and harassment, for all participants and their families.
Not criticize athletes in front of spectators, but reserve constructive criticism for later, in private, or in the presence of team members if others might benefit.
Accept decisions of the game officials and judges on the field and in competitions as being fair and called to the best ability of said officials.
Not criticize an opposing team, its athletes, coaches, or fans by word of mouth or by gesture.
Emphasize that good athletes strive to be good students and that both are physically and mentally alert.
Strive to make every athletic activity serve as a training ground for life, and a basis for good mental and physical health.
Remove from a game, competition or practice any athlete when even slightly in doubt about his/her health, whether or not as a result of injury, until competent medical advice is available.
Emphasize that winning is the result of good teamwork.
Not engage in excessive sideline coaching and shall not leave the bench area/coaches’ designated seating area to shout instructions from the sidelines or competition mat.
Together with team officials, be jointly responsible for the conduct and control of team fans and spectators at all times. Any fan who becomes a nuisance and out of control will be asked to leave.
Not use abusive or profane language at any time.
Not receive any payment, in cash or kind, for services as a volunteer or athlete involved in Pop Warner. This includes any coach, expert, consultant or choreographer, regardless of his/her roster status.
Not recommend or distribute any medication, controlled or over the counter, except as specifically prescribed by athlete’s physician.
Not permit an ineligible athlete to participate in a game/competition.
Not deliberately incite unsportsmanlike conduct.
Not possess or drink alcoholic beverages and/or use illegal substance(s) on either the game, practice field/practice area or competition venue.
Not smoke, vape and/or use smokeless tobacco on the field.
Uphold all rules and regulations regarding Pop Warner programs.
Refrain from engaging in any action within or outside Pop Warner which in PWLS sole & absolute discretion reflects negatively upon, or causes embarrassment to, the Pop Warner program.

If any of these rules are broken, Pop Warner or its member league shall have the authority to impose a penalty including permanent removal from the program.

Signature*

SCC Volunteer Application

Please provide three personal references