Please complete this application form if you are interested in becoming a Boys and Girls Club of Albany coach. Once you complete the form, click the Continue button at the bottom.

Name and address

First name:

Last name:

Title:

Street 1:

Street 2:

Street 3:

City:

State:

* Zip: *

Home phone:

OK to call me here

Work phone:

OK to call me here

Email address:

Gender:

Ethnicity:

Area of Interest

Listed below are all of our current program offerings. Please select which sport(s) you are interested in coaching.

Background Check- Required

Your Social Security Number and Driver License number are required to run a background check if you are over 18 years old. If you are under 18, please enter 000-00-0000. If you would like to provide this information over the phone, please enter 000-00-0000 and call McKena Roberts at 541-926-6666 ext. 220. We will delete this information from our database as soon as your background check has been submitted.

Date of birth:

Social Security Number:

Driver's License Number:

Have you ever been charged or convicted of a crime? If yes, please explain.

Code of Ethics and Injury Guidelines

Code of Ethics for coaches

The three-fold purpose of all our programs is:

1. To allow all youth an opportunity to participate.

2. To provide a valuable learning experience.

3. To allow the participants a chance to have fun.

As an adult volunteer in a youth sport program of the Boys & Girls Club, I have read, understand and will promote the three-fold purpose of this program. I understand that my responsibilities as youth sports volunteer are of great importance and that my actions are a very visible example to the youth I am involved with.

I also promise to uphold the specifics of the following code:

1. I will treat each individual (player, opposing coach, official, parent, and administrator) with respect and dignity.

2. I will do my best to learn the fundamental skills, teaching techniques, rules, and strategies of my sport.

3. I will uphold the authority of officials who are assigned to me, and make sure that myself, my team, and the parents respect them and have good sportsmanship throughout the season.

4. I will conduct my practices and games so that all players have an opportunity to improve their skill level through active participation.

5. I will cooperate with the administrators of our organization in the enforcement of rules and regulations, and I will report any irregularities.

6. I will refrain from swearing, smoking, or drinking alcoholic beverages during any activity involving my team.

7. I understand that it is my responsibility to protect myself, and the participants, and will avoid any one on one situation with the members of my team by communication with my parents.

Volunteer Coach Injury Guidelines

Safety should be the number one priority of all Boys & Girls Club coaches. The following guidelines should help you be able to minimize injuries, as well as know what to do in the event an injury occurs.

Minor injuries - As a coach for the Boys & Girls Club of Albany, you will be issued a first aid kit. Any minor injuries that may occur during a team practice should be easily taken care of with the use of this kit.

Major injuries – In the event that a player on your team does sustain a significant injury. Immediately call 911 for assistance and notify the parents. Don’t move an injured player until the extent of the injury is determined. An incident report needs to be filed with the Athletic Department in the case of a major injury taking place. Parent contact information, medical history, and emergency contact information is all included on the participation agreement/medical release forms provided in your coach’s packet. Please have this information with you at all times.

Prevention – Many injuries can be avoided by being pro-active:

• Survey your practice/game environment – look for any physical safety concerns on your field/court that might be potentially dangerous.

• Structure your practices so that players are in a situation where they are constantly supervised and understand expectations.

• Warm-up and stretch out your players before getting started in activity. This will minimize the risk of a strained or pulled muscle.

I acknowledge that I have read the above first aid

guidelines and agree to adhere to them throughout the course of my season.

I Agree