NPYB Coaches Application

First Name:

MIddle Name:

Last Name:

Division(s) to Coach: 5-7 Division
8-9 Division
10-13 Division
14-17 Division

Coaching Position: Head Coach
Asst Coach
Either - I just want ot help

Player's Name (optional):

Address:

City:

State:

Zip:

Phone Number:

Alternate Number:

Date of Birth:

Email:

T-Shirt Size: Adult Small
Adult Medium
Adult Large
Adult X-Large
Adult XX-Large
Adult XXX-Large

Coaching Experience:

Have you ever been charged of a misdemeanor or felony? If yes please explain:

County:

State:

Date:

Has a petition of Domestic Violence ever been filed against you? If yes please explain:

I, the undersigned, understand that coaching for NPYB, Inc. is a serious responsibility and that I will be a good role model for the players and league of NPYB, Inc. I understand that the background check will not necessarily preclude me from coaching; it is so there is full disclosure for the board. There will be a mandatory coaches meeting, and draft that I will be present at and give my full support to. By the signing of this form I am attesting that the information is truthful to the best of my knowledge. I understand that a full back ground check maybe done by the league. I understand that my picture may be taken and used for NPYB, Inc. purposes. I hold harmless NPYB, Inc. of any and all injuries, I understand that coaching a sport’s team can result in injuries and am taking full responsibility of any and all injuries regardless of fault.

I agree to the above terms