Windham Youth Cheerleading New Coach Application
Name
*
First Name
Last Name
Email
*
example@example.com
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.
Birth Date
*
-
Month
-
Day
Year
Date
Social Security Number (SSN)
*
Driver's License Number
*
Coaching Position Desired Note: Coaching assignment subject to registration needs, consideration given to children/parents in the program.
*
Kindergarten
1st Grade
2nd Grade
3rd Grade
4th Grade
5th Grade
6th Grade
7th Grade
8th Grade
Other
If you chose Other, please explain:
Experience – Please list your experience as an athlete:
*
Experience – Please list your experience as a coach:
*
Experience – Please list your experience with tumbling, stunting, choreography, etc.:
*
Special Training, Skills or Certifications (volunteering, CPR, nursing, childcare, youth groups, Sunday School, Scouts):
*
Have you had any other names in the past (i.e. maiden names)? Please list them all. If not input N/A.
*
Do you have children in a Windham Youth Cheerleading program? (circle one)
*
Please Select
Yes
No
If Yes above, Name of Cheerleader and Grade for Fall 2026:
References
For high school assistants, please include parent contact as Reference #1 below. For all others, please list two references (other than relatives) that can inform us about your abilities and qualifications for this position.
Reference #1 Name
*
First Name
Last Name
Reference #1 Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Reference #1 Email
*
example@example.com
Reference #1 Relationship:
*
Reference #2 Name
*
First Name
Last Name
Reference #2 Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Reference #2 Email
*
example@example.com
Reference #2 Relationship:
*
By providing my electronic signature, I certify that all information submitted to Windham Youth Cheerleading is true and accurate. I acknowledge that this signature serves as my agreement to this attestation and a background check and that I will also be required to review and sign a separate Code of Conduct. Signature
*
Date Signed:
Continue
Continue
Should be Empty: