PLEASE COMPLETE AND RETURN AS SOON AS POSSIBLE. THANK YOU FOR VOLUNTEERING!

Transcription

1 PLEASE COMPLETE AND RETURN AS SOON AS POSSIBLE. THANK YOU FOR VOLUNTEERING! Additional Documentation/Training Current Immunizations Records Valid CPR & First Aid Child Abuse Training Coaches Training Please contact the Sport s Director for upcoming training & certifications 60 th FSS/FSFY: 310 Fairchild Drive, Bldg / Travis AFB / Tel /Fax

2 Duties & Responsibilities: Job Description for Youth Sport s Volunteer Travis Air Force Base Position: Volunteer Coach for the Youth Sports Leagues 1. Full responsibility for overall supervision of his/her youth sport. Plan and supervise games, practices, and events. 2. In charge of assigning duties to assistant coaches and team assistants working in his/her sport. 3. Responsible for keeping practice periods for his/her sport within the confines of the time specified by the Youth Sports Director. 4. Responsible for the general upkeep and protection of equipment under his/her jurisdiction. 5. Directly responsible for a complete inventory of the equipment used for his/her sport. Coaches will sign in and out equipment used for the season. 6. Responsible for keeping records as requested by the Youth Sports Director. 7. Has the main responsibility for building good sportsmanship and developing positive public relations in the local community and Travis AFB. 8. Provide positive feedback to each player and areas of needed improvements. 9. Responsible for obtaining and keeping current CPR & First Aid training. 10. All coaches are required to attend the National Youth Sports Coaches Association training. 11. Teach the young athlete the fundamentals of the sport. 12. Encourage the involvement of the parents in the sport, i.e. bringing snacks. 13. Schedule and conduct parents and other necessary meetings. 14. Provide a safe and fun environment for the children. 15. Learn and follow all league rules, policies, and procedures. 16. Give each player equal playing time. 17. Put the feelings of the players ahead of your desire to win [this is a recreational league]. 18. Attend all league functions and participate in league activities. Qualifications: Successfully complete the application procedure and pass the required background check. Attend any scheduled coaching interview(s)/meeting(s). Successfully complete the National Youth Sports Coaches Association (NYSCA) certification. Be enthusiastic, patient, organized, and dependable. Again this is a recreational league; the focus is not on winning. I agree that I have read and understand the above job description for a youth sports league volunteer coaching position, and that I accept the terms of these duties/responsibilities. / / Print First & Last Name Signature Date

3 (Check only one) HEAD COACH ASSISTANT COACH PLEASE MARK THE SPORT YOU WOULD LIKE TO COACH/PRIORITIZE YOUR PREFERENCE BY AGE GROUP Baseball Name: Duty Soccer Flag Football Basketball Duty phone #: Personal Cell phone#: Address: DOB: Place of Birth: Are you planning to coach your child? If so, provide child s first & last name. First Name: Last Name: Age: First Name: Last Name: Age: First Name: Last Name: Age: Additional Information: How many years have you coached? Where have you coached? What sports have you coached? Describe your knowledge/expertise in the sport you would like to coach: The final selection of a coach is determined by general coaching experience and/or sport specific knowledge. In accepting this volunteer position, you agree to abide by the policies set forth by Youth Programs and understand a background check for child & drug abuse is required. Background check forms are attached. Please fill them out completely. Initial

4 AUTHORITY: 42 U.S.C AND 10 U.S.C Appendix C ACKNOWLEDGMENT OF RIGHTS AND CONSENT TO RELEASE RECORDS PRINCIPAL PURPOSE: To comply with Public Law , Section 231, and DoDI , Criminal History Background Checks on Individuals in Child Care Services. DISCLOSURE: Mandatory. In the case of an applicant for employment in a position involved with children under the age of 18, refusal to sign this form shall result in the employer s refusal to consider the application for employment. In the case of an incumbent of a position involved with children under the age of 18, refusal to sign this form shall result in removal from such position. EMPLOYEE ACKNOWLEDGMENT: 1. I have been advised and understand that the United States Air Force, as a Federal employer, has an obligation to require a record check as a condition of my employment in a position involved with children under the age of 18. I have been further advised that I have a right to obtain a copy of any criminal history report made available to such employer or potential employer and to challenge the accuracy and completeness of any information included in such report. 2. I understand that the record check will include the following: a. A State Criminal History Repository Check in the state where I currently reside and in states where I have formally resided; b. An Installation Records Check at all installations I have identified as residences during the preceding two years. This records check will include, at a minimum, a file check of Security Forces Management Information System (SFMIS) which affords global background investigative data for all Air Force installations; Family Advocacy s Air Force Central Registry which includes all drug and alcohol program files, medical treatment facility files, mental health, and life skills files; Family Housing files; and any other record checks as appropriate to the extent permitted by law; and c. A National Agency Check with Inquiries, including Federal Bureau of Investigation fingerprint check. d. A name check of the Dru Sjodin National Sex Offender Registry. 3. I hereby authorize any Federal, state, or local agency or office to release any record relating to me which is necessary to complete the record checks described above. SIGNATURE: TYPED OR PRINTED NAME: DATE: Appendix C

5 Appendix G REQUEST FOR INSTALLATION RECORDS CHECK (IRC) Medical Treatment Facility Records Name of Requesting Agency: NAF HUMAN RESOURCES OFFICE POC at Requesting Agency: Ollie Wilson Duty Phone: a. It is Air Force policy that Non-Appropriated Fund (NAF) employees and all volunteers working with or near children under 18 year of age must have an IRC. The following individual is being considered for either employment or a volunteer position in a DoD-sanctioned activity: a. APPLICANT NAME: b. APPLICANT SSN: c. APPLICANT DATE OF BIRTH: d. PROSPECTIVE POSITION: e. NAME OF MILITARY SPONSOR: f. SSN OF MILITARY SPONSOR: g. CURRENT ADDRESS: b. The Privacy Act protects the information in this letter. Air Force personnel (military or civilian) must conduct this IRC. Information contained herein should be protected as sensitive medical information. c. The applicant and the applicant s sponsor acknowledge that both of the social security numbers provided above will be submitted for an Air Force Central Registry check to verify the applicant has no documented history of perpetrating child maltreatment. Signature of Applicant (date) Signature of Sponsor (date) d. For Family Advocacy Program A Medical Facility Records Check of AHLTA, Mental Health Records and Family Advocacy Records, to include an Air Force Central Registry Check reveals: No pertinent information exists Information exists that requires review Date Name & Position of FAP Official Signature Appendix G

6 DEPARTMENT OF THE AIR FORCE 60 TH FORCE SUPPORT SQUADRON (AMC) Travis AFB Family Services Flight Non-Conviction Statement I, have not been arrested or convicted of any crime involving children, drugs, or alcohol. I understand that future incidents of the above could result in not volunteering and/or coaching in the Family Services Flight. Signature / / Date Youth Programs - FSFY Facility