Basketball & Volleyball Volunteer Coach Application

Please complete this form if you are interested in applying to be a volunteer coach with a THPRD youth volleyball or basketball team.

This form requires you to submit a social security number. If you do not have this, please submit your passport number instead. If you do not have this information or have questions, please contact Volunteer Services staff at 503-619-3941.

Coaching Agreement

THPRD's Youth Sports Programs provide an enjoyable learning environment for youth to develop physically, socially and personally. The purpose of a volunteer coach is to teach responsibility and commitment, develop sports skills, teach cooperation and develop a positive attitude towards authority while providing a fun and enriching experience. A coach assumes the role of a teacher and carries out lesson plans to develop skills through progressive lessons, emphasizing positive sports values and encouraging a life long interest.

By completing this application, you must recognize,agree with and make your best effort to execute all of the duties and responsibilities as established by THPRD staff.

Athletic Center staff will contact you regarding your program assignments and additional information pertinent to your volunteer position.

Contact Information

Preferred first name/ Nombre preferido:

Last name/ Apellido:

Legal First Name/Nombre oficial:

Street Address/ Dirección:

City/Ciudad:

State/Estado:

* Zip/Código Postal: *

Teléfono/ phone:

Secondary phone:

Text Alerts/ Alertas de Texto phone:

Email/ Correo electrónico:

Date of birth/ Fecha de nacimiento:

Gender/Género:

T-Shirt Size/Talla de Camiseta:

Employer/Empleador:

Emergency Contact Information

If you are under 18 years of age, you must list your parent/legal guardian's contact information.

First name/Nombre:

Last name/Apellido:

Primary/Teléfono phone:

Relationship/Relación:

Coaching Position Preference

Position Preference/ Puesto de Pref.:

1. Head Coach/ Entrenador(a) Principal

2. Assistant Coach/ Asistente de Entren

Assignment Preference/ Asignat. de Pref:

1st choice:

2nd choice:

If you are a parent of a child on the team, list the child's full name, grade, gender & school:

Assistant Coach & Team Preference

If you are applying as an Assistant Coach, provide the name of your Head Coach below;

If you are coaching more than one team, please list all of the team names; or

If you are looking for a team to help coach, note that here.

Coaching Background (check all that apply)

Coaching Certs./ Cert. como Entren.:

American Sport Education Program (ASEP)

Coaching Effectiveness Training (CET)

Current CPR Card

Current First Aid Card

National Youth Sport Coaches Ass(NYSCA)

Parent Sport Orientation (PSO)

Positive Coaching Alliance (PCA)

Describe any other related training/ experience (PE Degree, previous coaching experience, etc.):

References

1

2

First name/Nombre:

Last name/Apellido:

Primary/Teléfono phone:

Email/Correo electrónico:

Demographic Information

In order to best serve the region's communities as broadly as possible, THPRD needs to understand who our programs currently serve. Any information you provide is helpful.

Parent/Guardian Consent (required for youth)

If you are under 18 years of age, parent/guardian permission is required. By entering your name below, you are stating, as the applicant's parent/guardian, that you give your consent for the applicant to participate in volunteer activities with THPRD.

If you are age 18 and over, please skip this section.

First name/Nombre:

Last name/Apellido:

Email/Correo electrónico:

Background Consent - Part 1 (required if age 18+)

THPRD conducts a criminal background check for adult volunteers (ages 18+) involved in ongoing volunteer programs. These checks are conducted with your initial volunteer application and may be conducted at any time while you are volunteering. We don’t anticipate any problems, but we are committed to maintaining a safe environment for our patrons.

The information you submit through this online form is protected using Secure Sockets Layer (SSL) technology. This is the same technology used by banks to protect online banking services and online merchants to protect credit card information. Once your data reaches our volunteer database, it is protected by hardware firewalls, secure servers, database encryption, and other security measures.

NOTE: Only provide your passport number, if you do not have a social security number.

Social Security #/ No. de Seguro Social:

Passport #/ No. de Pasaporte:

List all the states of residence since age 18 & any other names used (aliases, maiden names, etc.):

Background Consent - Part 2

If you have been convicted of an offense other than a minor traffic violation and/or juvenile offense, please provide details below. Failure to disclose convictions will automatically disqualify your application.

Indicate the date, charges, disposition, & the state/county in which the offense occurred:

Access to Your Online Volunteer Account

We provide you online access to check your schedule, update your information, enter your hours and learn about upcoming volunteer opportunities. Please select the password you would like to use to access your online volunteer account.

Please enter a password that:

Is between 6 and 30 characters long

Password:

Confirm password:

Volunteer Insurance Waiver & Consent Agreement

Read this document completely before signing. Its effect is to release the Tualatin Hills Park & Recreation District ("THPRD") and its representatives from any liability resulting from your participation as a volunteer and to waive all claims for damages or losses against THPRD and its representatives that may arise from such participation.

Staff or volunteers may photograph or video volunteers and use the images for volunteer appreciation and outreach purposes. Images are the property of THPRD. By signing this form, you acknowledge and agree to such use.

As a volunteer, you are NOT covered by the Park District's Workers Compensation program. You are, therefore, urged to have your own health insurance in the event you are injured while performing your volunteer duties.

You ARE covered by THPRD's General Liability Fund. This will protect you in the event of property damage or accidental injury to the public as a result of your performance of volunteer duties assigned by THPRD.

Volunteers are not authorized to drive THPRD or personal vehicles as part of his/her duties, but may on occasion be authorized to operate off-road equipment. If you operate off-road equipment, you must have a valid Oregon Driver's License. You will be covered for property damage or bodily injury to others resulting from an accident. You should have your own health insurance to cover yourself.

Release. In consideration of the right to participate in volunteer activities, I hereby forever waive, release, and discharge THPRD and its individual directors, officers, agents, employees, volunteers, representatives, officials, and any other persons or entities acting on its behalf, and their successors and assigns (the "Released Parties") from any and all liability, claims, demands, actions, expenses (including attorney fees), damages, judgments, liabilities, and causes of action whatsoever, known or unknown (together, "Claims") arising from the fault or negligence of the Released Parties, including without limitation Claims for or related to death, disability, personal injury, property damage, property theft, or actions or injury of any kind which may occur to me arising out of participation in volunteer activities. The releases and waivers provided under this paragraph do not apply in cases of the Released Parties' gross negligence or willful misconduct.

I have read and understand the foregoing information on volunteers and insurance. If I am injured, I understand I will not have a claim against THPRD for injury and damages. I also give my consent to THPRD to conduct a background check. If your child is under 18 years old, the parent/guardian is responsible for arranging timely transportation to and from the volunteer activity.

All Tualatin Hills Park & Recreation District ("THPRD") volunteers 18 years of age and older must read and sign this acknowledgment. Failure to submit a signed acknowledgment will prevent you from volunteering for THPRD.

The novel coronavirus ("COVID-19") is a contagious disease that has been declared a global pandemic by the World Health Organization. Although some individuals with COVID-19 may never become symptomatic or may not show symptoms for a period of time, COVID-19 can be life-threatening. Health experts are still learning how COVID-19 is spread from infected persons to others, though they believe that transmission may occur through the air, close personal contact, and contact with a surface that has the virus on it. There is no current vaccine for COVID-19. In addition, the Centers for Disease Control and Prevention have identified certain health factors that put individuals at higher risk for severe illness in the event they contract COVID-19. These health factors can be found at https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/people-at-higher-risk.html.

The health and safety of volunteers is important to THPRD. In an effort to mitigate the risk of COVID 19 spreading at THPRD events and activities, THPRD is implementing a number of new safety rules and protocols, including:

- Pre-registering volunteers for projects;

- Asking volunteers to bring their own gloves, hand sanitizer, face masks, tools, water, and snacks;

- Maintaining smaller group sizes and abiding by the 6-foot physical distancing guidelines;

- Requiring volunteers to wear face masks when indoors or physical distancing is not an option;

- Reducing touchpoints; and

- Increased sanitation procedures.

Volunteers must review the complete list of THPRD's COVID-19 safety rules for volunteers, which will be provided in advance of the initial volunteer shift. Volunteers are expected to follow all COVID-19 safety rules while volunteering at THPRD events and activities. In addition, volunteers may not attend a THPRD volunteer activity or event if:

- Within the prior 14 days, the volunteer has had a presumptive positive test for COVID-19, a positive test for COVID-19, or direct exposure to a person infected with COVID-19.

- Within the prior 10 days, the volunteer or anyone within the volunteer's household developed a new cough, fever, shortness of breath, or other symptoms of COVID-19. In addition to this 10-day period, volunteers must be without a fever (without the use of fever reducing medication) or other COVID-19 symptoms for 72 hours before volunteering at a THPRD activity or event. A list of symptoms can be found on the COVID-19 websites for the Oregon Health Authority (https://govstatus.egov.com/OR-OHA-COVID-19) and Centers for Disease Control and Prevention (https://www.cdc.gov/coronavirus/2019-nCoV/index.html).

Volunteers must report to Melissa Marcum, mmarcum@thprd.org or 503-619-3941, as soon as possible if, within 14 days of volunteering for THPRD, the volunteer has a presumptive positive test for COVID-19, a positive test for COVID-19, or direct exposure to a person infected with COVID-19. THPRD may be required to notify public health authorities if it learns that a volunteer has or has been exposed to COVID-19.

Despite the COVID-19 safety rules and protocols that THPRD is implementing, THPRD cannot eliminate the risk that volunteers are exposed to COVID-19 during a THPRD volunteer activity or event.

Please direct any questions or concerns about THPRD's COVID-19 safety rules and protocols for volunteer events and activities to Melissa Marcum, mmarcum@thprd.org or 503-619-3941.

By my signature below:

- I acknowledge that I have read this COVID-19 Acknowledgement of Risk and Agreement to Follow Safety Rules.

- I agree to follow and/or ensure that my child follows all THPRD COVID-19 safety rules for volunteers and comply with all safety instructions from THPRD staff members.

- I understand and acknowledge that despite THPRD's COVID-19 safety rules and protocols, THPRD cannot eliminate the risk that I and/or my child are exposed to COVID-19 at a THPRD volunteer activity or event.

- I attest that I and/or my child are voluntarily participating in a THPRD volunteer activity or event.

- By clicking 'I Agree' below, I fully understand the information provided herein and agree to the terms.

I Agree

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