Middletown Little League Volunteer Application

Please fill out this form completely. Submitting this application does not guarantee an appointment to manage or coach. In addition to this volunteer application, you must also create an online coaching profile for yourself and upload a copy of your photo drivers lisc, Rutgers certification card and Concussion Training Cert. Once your online profile is created it will need to be linked to your childrens profile if it is not already. Thank You.

Middletown (NJ) Little League Volunteer Application

Baseball and Softball Program of Middletown Youth Athletic Association

Last Name *

First Name *

Social Security Number (Mandatory for Background Check)

Date of Birth (MM/DD/YYYY)

Street Address *

City *

State

Zip Code

Email Address

Cell Phone

Home Phone

Occupation

Employer

Employer Address *

Skills, Prof Training, Hobbies *

Community Affiliations (Clubs, Service Orgs) *

Previous Volunteer Experience (including Baseball/softball and year) *

Do you have children in the program? *

Yes

If yes, list childs' full name and what division? *

Special Certifications (CPR,Medical,etc) *

Do you have a valid drivers liscence? *

Yes

Drivers Liscence # / State issued (Mandatory for Background Check)

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

Yes

If yes, describe each in full:

Are there any criminal charges pending against you regarding any crime(s) involving or against a minor?
Yes No

If yes, describe each in full:

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

Yes

If Yes, explain:

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

Manager	Asst Coach	League Official	Division Coordinator	Umpire	Field Mx
Concession Stand	Other

In which division would you like to manage and/or coach?

None	Tball Clinic (4 yr olds)	TBall (Coed 4-6)	Rookie Boys Baseball (Coach Pitch 6-8)	Rookie Girls Softball (Coach Pitch 6-8)	Minor Boys Baseball (8-9)	Minor Girls Softball (8-10)	Major Girls Softball (10-12)	Major Boys Baseball (10-12)	Intermediate Boys Baseball (50/70) (12-13)	Junior/Senior Girls Softball (13-16)	Senior Boys Baseball (14-16)
Big League Baseball (17-18)

Have you completed the Rutgers Safety Course Certification?

Yes No

Have you completed Online Concussion Training

Yes No

Why do you want to volunteer to manage or asst coach? *

Please list three references (Name and Phone number) who have knowledge of your participation a volunteer in a youth program: *

If I am selected as a manager or asst coach, I understand that the president, ratified by the Board of Directors, made my appointment and expires at the end of the current playing season. I acknowledge the Little League Baseball Inc. requirement of being a positive role model at all times for players, coaches, parents and spectators, and I agree to be a positive role model. I understand that each manager and two asst coaches per team will be given volunteer credit to satisfy the volunteer family bond requirement. I agree to obtain, read, and strictly comply with all rules and regulations of Little League Baseball Inc. and MLL. I acknowledge and agree that this shall specifically include, but is not necessarily limited to the following: • Manager and Coaches Code of Conduct • Uniforms and Equipment Regulations • Safety Code for Little League • Local Rules • Official Regulations and Playing Rules I acknowledge and agree that the Board of Directors, at its sole discretion, shall have the authority to discipline, suspend, or terminate the membership of any member (including myself). This is particularly true when the conduct of such person is considered detrimental to the best interests of the Middletown Little League and/or Little League Baseball. Further, I agree to respect and comply with all requests and decisions by the Middletown Little League Board of Directors. I understand that team assigned equipment is League property and represents a significant cost to Middletown Little Little League and I understand that my team’s (more specifically the Manager’s) failure to promptly return team assigned equipment on time may jeopardize my future association with MLL Little League. I understand that the official scorebook is league property and that I am required to produce when requested by a member of the board. Finally, I understand and agree that my failure at any time to strictly adhere to the aforementioned, at the sole discretion of the Board of Directors, may result in a variety of sanctions up to and including the immediate termination of my association with Middletown Little League. 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.