Little League - Volunteer Application Form
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1Little League
V olunteer Application
®
Do not use forms from past years. Use extra paper to complete if additional space is required.
A copy of valid government issued photo identification must be attached to
Please list three references, at least one of which has knowledge of your
complete this application.
participation as a volunteer in a youth program:
Name __________________________________ Date __________________
Name
Phone
Address _______________________________________________________
_____________________________________________________________
City ____________________________ State _________ Zip ____________
_____________________________________________________________
Home Phone ___________________________________________________
Business Phone _________________________________________________
_____________________________________________________________
Date of Birth ___________________________________________________
As a condition of volunteering, I give permission for the Little League
Occupation _________________________ Social Security # ____________
organization to conduct a background check on me, which may include a review
Employer ______________________________________________________
of sex offender registries, child abuse and criminal history records. I understand
that, if appointed, my position is conditional upon the league receiving no
Address _______________________________________________________
inappropriate information on my background. I hereby release and agree to hold
Special professional training, skills, hobbies: __________________________
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,
Community affiliations (Clubs, Service Organizations, etc.):
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
Previous volunteer experience (including baseball/softball and year):
Directors for violation of Little League policies or principles.
_____________________________________________________________
Do you have children in the program? Yes
No
Applicant Signature _________________________________ Date _______
If yes, at what level? _____________________________________________
Special Certification (i.e. CPR, Medical, etc.): _________________________
Applicant Name(please print or type) ________________________________
Do you have a valid driver’s license: Yes
No
Driver’s License#: _______________________________ State ___________
NOTE: The local Little League and Little League Baseball, Incorporated will not discriminate
against any person on the basis of race, creed, color, national origin, marital status, gender, sexual
Have you ever been convicted of or plead guilty to any crime(s): Yes
No
orientation or disability.
If yes, describe each in full: ________________________________________
_____________________________________________________________
Local League Use Only:
Have you ever been refused participation in any other youth programs? Yes
No
If yes, explain: __________________________________________________
Background check complete by league officer __________________________
_____________________________________________________________
on ___________________________________________________________ .
_____________________________________________________________
System(s) used for background check (minimum of one must be checked):
In which of the following would you like to participate? (Check one or more.)
Sex Offender Registry
Criminal History Records
League Official
Coach
Umpire
Field Maintenance
Only attach to this application copies of background check reports that reveal convictions of this
applicant.
Manager
Scorekeeper
Concession Stand
Other
d:\mydocuments\operations\League Supplies 2004
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