EJRP Youth Basketball Coach Registration Form 2014

Thank you for your interest in coaching youth basketball this winter. Our program would not be successful without volunteers like you. Please take a few minutes to complete this form so that we have a record of your interest in coaching. We will be in contact with our coaches in November regarding a coaching clinic. In addition to completing this form, you will also need to complete the CCSU Volunteer Form online. Thanks again!

Question Title

* 1. Please complete the following information:

Coach's Name:

Address:

Primary Phone:

Secondary Phone:

Email Address:

Question Title

* 2. Which Age Group(s) would you like to coach?

PeeWee (Kindergarten)

Half Courts (1st Grade)

2nd-3rd Grade Girls

2nd-3rd Grade Boys

4-5th Grade Girls

4-5th Grade Boys

6-8th Grade Boys

Comments

Question Title

* 3. If you have a child playing in the league please complete the following:

Child's Full Name:

Child's Grade:

Do you want your child on your team?

Question Title

* 4. If you have a co-coach that you wish to work with please provide their information below (they will also need to complete the registry check...print them a copy):

Co-coaches Name:

Address:

Primary Phone:

Secondary Phone:

Email:

Question Title

* 5. If the co-coach has a child playing in the league please complete the following:

Child's Full Name:

Child's Grade:

Do you want this child on your team?

Question Title

* 6. Are there any evenings that you absolutely cannot coach?

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Comments

Question Title

* 7. If you have any additional information that you feel is important to share before the season, please enter it below:

Don't forget to complete the CCSU Volunteer Form. Thank you!