Walkertown Little League

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Volunteer Application

A COPY OF VALID GOVERNMENT ISSUED PHOTOIDENTIFICATION
MUST BE ATTACHED TO COMPLETE THIS APPLICATION.

* Name:

* Date of application:

* Address:

* Home phone:

Business Phone:

Email Address:

* Date of Birth:

* Occupation:

* Social Security Number:

Employer:

Employer Address:

Special professional training, skills, hobbies::

Community affiliations (Clubs, Service Organizations, etc.)::

Previous volunteer experience (including baseball/softball and year)::

* Do you have children in the program?:

If yes, in what division?:

Special Certification (i.e. CPR, Medical, etc.)::

* Do you have a valid driver’s license?:

* Driver’s license number and State:

* Have you ever been convicted of or plead guilty to any crime(s)?:

If yes, describe each in full::

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

If yes, explain::

In which of the following would you like to participate? (Check one or more.)

League Official

Coach

Umpire

Field Maintenance

Manager

Score Keeper

Concession Stand

Other

Please list three references, at least one of which has knowledge of your
participation as a volunteer in a youth program:

* Name, address, phone:

As a condition of volunteering, I give permission for the Little League
organization to conduct a background check on me, which may include a review
of sex offender registries, child abuse and criminal history records. I understand
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 the local Little League, Little League Baseball,
Incorporated, the officers, employees and volunteers thereof, or any other person
or organization that may provide such information. I also understand that,
regardless of previous appointments, Little League is not obligated to appoint
me to a volunteer position. If appointed, 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 violation of Little League policies or principles.

Signature:

Date:

* indicates required fields

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Volunteer Application