CAVE CREEK/CAREFREE YOUTH FOOTBALL
HEAD COACH APPLICATION
(All information provided is Confidential)
Personal Information (please print all information )
Full Name: ______
Last First Middle
Address: ______City:______St:_____Zip:_____
Home Phone: ______Work Phone: ______Cell Phone: ______
Email: ______
Employer: ______Occupation: ______
Employer Address: ______City: ______St: ______
Drivers License#:______St:______Exp:______
Do you have Auto Insurance? ___Yes ___ No
Football Coach Information:
Circle Division(s) in which you wish to coach this year (estimate division you expect your child to be in):
Flag Mighty Mite Jr. PeeWee PeeWee Jr. Midget Midget
Child’s name whose team you wish to coach:
If not selected as a head coach, I am interested in serving as an assistant coach this year (check as appropriate)
[ ] In the same division [ ] In another division (list division and child’s name):
List the team that you are applying to be the Head Coach: ______
Reason why: ______
Can you attend all Practices, Games, Board Meetings and Clinics? ___Yes ___No
If not, who would act in your absence? ______
Have you ever been suspended or expelled as a Coach in any youth sport organization? ___Yes ___No
If yes, explain: ______
______
Football Background:
(Position) (Team) (League) (Year) (Record)
______
______
______
Give your reason for wanting to participate in Cave Creek/Carefree Football: ______
______
______
Experience working with other youth organizations: ______
______
Additional information:
Character References: [List two personal references (no relatives) for character verification]
Name: ______Phone:______
Name: ______Phone:______
Have you ever been convicted of a felony? ___Yes ___No
If yes, when and where? ______
______
Have you ever been convicted of any crimes against children? ___Yes ___No
If yes, when and where? ______
______
Other than the above, is there any fact or circumstance involving your background that would call into
question you being trusted with the supervision, guidance and care of young people? ____Yes ____No
If yes, explain: ______
______
______
I understand that:
A. The information that I have provided may be verified, if necessary, by obtaining a record check and/or
contacting persons or organizations that may have information concerning me. I hereby release and
agree to hold harmless any person organization that provides information. I also agree to hold harmless
Cave Creek / Carefree Youth Football Inc. and the officers and volunteers thereof and any person or
organization that provides information.
B. In signing this application, I affirm that the information I have given is true and correct.
Signature of Applicant: ______Date: ______
Board: Approval Disapproval Date: ______
Team Assigned: ______
Notes: ______
Cave Creek/Carefree Association of Youth Football and Cheer, Inc. does not limit participation in its activities on the basis of disability, race, color, national origin, gender or religious preference.