The 2012 Virgin Islands Track & Field Federation COACH Registration Form
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The Virgin Islands Track & Field Federation
COACH Registration Form 2012)
To be in good standing with The Virgin Islands Track and Field Federation, you are required to complete all the following questions, in addition you are required to accept and abide by The Coach's Code of Conduct. Upon completion, you are required to submit a passport-quality photo and pay the annual $25.00 VITFF registration fee (see mailing address and email address below). You will then receive your official VITFF number and Registration Card. You will then be eligible for VITFF, V.I. Olympic Committee and IAAF benefits and privileges.
1
. Your Status for 2012
Your Status for 2012
New Registration:
Registration Renewal:
2
. Please provide accuarate personal information:
Please provide accuarate personal information:
Last Name:
Middle Name:
First Name:
Passport Number:
Passport Issue Date:
Passport Expiration Date:
Where was your Passport issued(you are required to provide a scanned color copy of your passport to the VITFF with this registration):
Mailing Address/City:
State:
Country:
Zip Code:
Home Address/City:
State:
Country:
Zip Code:
Home Telephone Number:
Work Telephone Number:
Cell Telephone Number:
Fax Number:
Email Address:
Website Address:
3
. Sex:
Sex:
Male:
Female:
*
4
. What is your age?
What is your age?
*
5
. What is your date of birth:
[DD/MM/YYYY] [ie. 01/10/1988]
What is your date of birth: [DD/MM/YYYY] [ie. 01/10/1988]
*
6
. Are you a United States Citzen:
Are you a United States Citzen:
Yes:
No:
7
. If you are NOT a United States Citizen, what is your country of citizenship:
If you are NOT a United States Citizen, what is your country of citizenship:
8
. If you are not a United States Citizen and live in the United States, what is your official Status (you are required to provide a copy of your official documentation to the VITFF along with this registration?
If you are not a United States Citizen and live in the United States, what is your official Status (you are required to provide a copy of your official documentation to the VITFF along with this registration?
9
. You are affiliated with:
You are affiliated with:
A School
A Club
An Organization
A College/University
Military
Other
10
. Indicate from the above with which you are affiliated?
Indicate from the above with which you are affiliated?
11
. Please check the appropriate sport code:
Please check the appropriate sport code:
Track
Field
Road Running/Long Distance Running
Cross-Country Running
Ultra-Marathon Running
Mountain/Trail Running
Race Walking
12
. What is your occupation other than track and field coach?
What is your occupation other than track and field coach?
13
. Are you an IAAF Certified coach? If yes, what is your level of certification?
Are you an IAAF Certified coach? If yes, what is your level of certification?
14
. Have you received formal coaching instruction from other institutions? If so, where, what and when?
Have you received formal coaching instruction from other institutions? If so, where, what and when?
15
. What event/s do you specialize?
What event/s do you specialize?
Event 1.
Event 2.
Event 3.
Event 4.
Event 5.
*
16
. Do you have medical insurance:
Do you have medical insurance:
YES:
NO:
17
. Have you ever tested positive for performance enhancing drugs or recreational/illegal drugs?
Have you ever tested positive for performance enhancing drugs or recreational/illegal drugs?
Yes:
No:
18
. What is the name of your insurance company and what insurance coverage do you have?
What is the name of your insurance company and what insurance coverage do you have?
19
. If you answered yes to question #17, please provide details here:
If you answered yes to question #17, please provide details here:
*
20
. Have you ever been convicted of a crime?
Have you ever been convicted of a crime?
YES:
NO:
21
. If you answered yes to question #19 please provide details here:
If you answered yes to question #19 please provide details here:
*
22
.
Virgin Islands Track and Field Federation
Coaches Code of Conduct
The Coaches Certification and Education System (CESC) is provided at no personal cost to you by the International Olympic Committee (IOC) Solidarity, the Virgin Islands Olympic Committee (VIOC) the International Association of Athletics Federations, the IAAF Regional Development Center San Juan (RDC) and the Virgin Islands Track and Field Federation(VITFF). They believe that sportsmanship is a core value and its promotion and practice are essential. Coaches have a duty to assure that their athletes and their teams promote the development of good character. This code of conduct applies to all coaches involved in athletics (track and field) and related activities.
1. The coach will promote academics and the educational process.
2. The coach will teach, enforce, advocate, model, and promote the development of good character to include: a) Trustworthiness b) Respect c) Responsibility d) Fairness e) Caring f) Citizenship
3. The coach will respect participants, officials, opponents, parents, and all others involved.
4. The coach will promote fair play and uphold the spirit of the rules in the activity.
5. The coach will model appropriate behavior at all times.
6. The coach will adhere to the rules and regulation of the Virgin Islands Track and Field Federation, the Virgin Islands Olympic Committee and its assigns at all times.
7. The coach will complete the annual registration and review process established by the VITFF.
8. The coach will abide by all rules, regulations, laws of government of the Virgin Islands and countries/jurisdictions applicable while visiting for competition or official business or otherwise.
9. The coach will recognize and abide by and participate in the anti-doping programs mandated by the IOC/NOC, IAAF/VITFF.
10. The coach will maintain and enhance the dignity and self-esteem of members and participants of the VITFF by: Showing respect to all individuals regardless of gender, ethnic or racial origin, sexual orientation, age, marital status, religion, political belief, disability or economic status. Focusing comments or criticism appropriately and avoiding public criticism of athletes, coaches, officials, organizers, managers, volunteers, staff, spectators, members and families of members.
I have read and understand the requirements of this Code of Conduct and acknowledge that I may be disciplined if I violate any of its provisions.
______________________ ______________________ _____________
Print your name here: Signature Date
Virgin Islands Track and Field Federation Coaches Code of Conduct The Coaches Certification and Education System (CESC) is provided at no personal cost to you by the International Olympic Committee (IOC) Solidarity, the Virgin Islands Olympic Committee (VIOC) the International Association of Athletics Federations, the IAAF Regional Development Center San Juan (RDC) and the Virgin Islands Track and Field Federation(VITFF). They believe that sportsmanship is a core value and its promotion and practice are essential. Coaches have a duty to assure that their athletes and their teams promote the development of good character. This code of conduct applies to all coaches involved in athletics (track and field) and related activities. 1. The coach will promote academics and the educational process. 2. The coach will teach, enforce, advocate, model, and promote the development of good character to include: a) Trustworthiness b) Respect c) Responsibility d) Fairness e) Caring f) Citizenship 3. The coach will respect participants, officials, opponents, parents, and all others involved. 4. The coach will promote fair play and uphold the spirit of the rules in the activity. 5. The coach will model appropriate behavior at all times. 6. The coach will adhere to the rules and regulation of the Virgin Islands Track and Field Federation, the Virgin Islands Olympic Committee and its assigns at all times. 7. The coach will complete the annual registration and review process established by the VITFF. 8. The coach will abide by all rules, regulations, laws of government of the Virgin Islands and countries/jurisdictions applicable while visiting for competition or official business or otherwise. 9. The coach will recognize and abide by and participate in the anti-doping programs mandated by the IOC/NOC, IAAF/VITFF. 10. The coach will maintain and enhance the dignity and self-esteem of members and participants of the VITFF by: Showing respect to all individuals regardless of gender, ethnic or racial origin, sexual orientation, age, marital status, religion, political belief, disability or economic status. Focusing comments or criticism appropriately and avoiding public criticism of athletes, coaches, officials, organizers, managers, volunteers, staff, spectators, members and families of members. I have read and understand the requirements of this Code of Conduct and acknowledge that I may be disciplined if I violate any of its provisions. ______________________ ______________________ _____________ Print your name here: Signature Date
*
23
. To be eligible for a Virgin Islands Track & Field National Team, athletes, coaches, officials, volunteers are required to complete this form and meet applicable criteria.
The annual registration fee is $25.00
Please send your payment to:
The Virgin Islands Track and Field Federation
P.O. Box 223094
Christiansted, St. Croix,
Virgin Islands 00822
To register with the VITFF logon to: http://virginislandspace.org
Please email passport-size photograph to: isv@mf.iaaf.org
Please email color copy of your passport to: isv@mf.iaaf.org
email address: isv@mf.iaaf.org
By registering with the VITFF you are supporting the development of track and field in the Virgin Islands. The Virgin Islands Track and Field Federation is a non-profit organization affiliated with The International Federation of Athletic Federations, The Virgin Islands Olympic Committee, the North America, Central America and Caribbean Athletics Confederation and the Central America and Caribbean Athletics Confederation...
Please share in a few words, your goals and objectives in track and field...
To be eligible for a Virgin Islands Track & Field National Team, athletes, coaches, officials, volunteers are required to complete this form and meet applicable criteria. The annual registration fee is $25.00 Please send your payment to: The Virgin Islands Track and Field Federation P.O. Box 223094 Christiansted, St. Croix, Virgin Islands 00822 To register with the VITFF logon to: http://virginislandspace.org Please email passport-size photograph to: isv@mf.iaaf.org Please email color copy of your passport to: isv@mf.iaaf.org email address: isv@mf.iaaf.org By registering with the VITFF you are supporting the development of track and field in the Virgin Islands. The Virgin Islands Track and Field Federation is a non-profit organization affiliated with The International Federation of Athletic Federations, The Virgin Islands Olympic Committee, the North America, Central America and Caribbean Athletics Confederation and the Central America and Caribbean Athletics Confederation... Please share in a few words, your goals and objectives in track and field...
24
. Now that you have registered with the Virgin Islands Track and Field Federation, once it has been determined that you are eligible and qualified for a V.I. National Track and Field Team, you will be issued a V.I. National Team Uniform provided by Mizuno the sponsor for V.I. Track and Field. Please proved the requested information listed below.
The Mizuno uniforms are sized according to Japanese sizes, if you received a uniform for 2010, please provide sizes according to that uniform, otherwise, please be careful to provide USA sizes and make sure that you allow for accurate fitness:
:
Now that you have registered with the Virgin Islands Track and Field Federation, once it has been determined that you are eligible and qualified for a V.I. National Track and Field Team, you will be issued a V.I. National Team Uniform provided by Mizuno the sponsor for V.I. Track and Field. Please proved the requested information listed below. The Mizuno uniforms are sized according to Japanese sizes, if you received a uniform for 2010, please provide sizes according to that uniform, otherwise, please be careful to provide USA sizes and make sure that you allow for accurate fitness: :
1. Training Shoe Size
2. Competition shoe size
3. Competition top size (chest size)
4. Competition shorts size (waist size)
5. Tee-Shirt size (chest size)
4. Warm-up Jacket (chest size)
5. Warm-up pants size (waist size, leg length)
6. Tight size
7. Your height
8. Your weight
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