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2. Date*
3. Name*
5. Email Address*
7. Phone Number*
9. Your Child's Name*
11. School*
13. Grade*
15. Age*
17. Do you give Ogden City permission to conduct a criminal background check?*

    1. Yes
    2. No

    It is Ogden City policy that all volunteers who want to work with vulnerable populations that includes children under age 18, senior citizens ages 60 or older and or persons with physical or mental disabilities must give Ogden City permission to conduct a criminal background check and provide residency verification for last 10 years. Misrepresentation or omission of facts will result in disqualification of your application to volunteer.

    Automatic disqualification: An applicant shall be disqualified to work with vulnerable populations on behalf of the Department if he/she has ever been sanctioned for any criminal conduct described as follows:

    1. Any crimes against minors, seniors or persons with disabilities or any sexual offense

    2. Any felony conviction involving violence

    3. Any felony conviction within prior 7 years

    4. Any criminal offense that is drug related within 3 prior years

    5. Any criminal offense that is alcohol related, including DUI, within the prior year

    6. More than two criminal offences that are drug or alcohol related, including DUI within 5 Prior years

    Discretionary Disqualification: An applicant may be disqualified to work with vulnerable populations of behalf of the Department, at the reasonable discretion of the supervising division manager, if any of the following circumstances exist:

    1. Applicant has been sanctioned for one or more criminal offenses not described in the section on automatic disqualification and the offense(s) reasonably raises the possibility of risk of neglect, abuse, harm, or detriment to vulnerable populations if the same offense(s) or similar conduct were repeated in the presence of the vulnerable populations that applicant will be working with.

    2. Applicant has a history of conduct know to the Department of unprofessional, dishonest, unethical, unsportsmanlike, rule-breaking, reckless, or other inappropriate behavior, or violation of court orders, which in the view of the Department demonstrate that vulnerable populations will not be well-serves by supervised interaction with or mentoring by application.

19. Do you have a criminal history or any conduct that would prevent you from working as a volunteer coach in our youth program as described above?*

    1. Yes
    2. No
21. Are you a returning coach from last season?*

    1. Yes
    2. No
23. Code of Conduct/Background Acknowledgement*

    • I will place the emotional and physical well-being of my players ahead of a Personal desire to win.

    • I will treat each player as an individual, remembering the large range of emotional and physical development for the same group.

    • I will do my best to provide a safe playing situation for my players.

    • I will promise to review and practice basic first aid principles needed to treat injuries of my players.

    • I will do my best to organize practices that are fun and challenging for all my players.

    • I will lead by example in demonstrating fair play and sportsmanship to all my players.

    • I will be knowledgeable in the rules of each sport that I coach, and I will teach these rules to my players.

    • I will use those coaching techniques appropriate for all of the skills that I teach.

    • I will remember that I am a youth sports coach, and that the game is for children and not adults

    I have read and understand Ogden City’s Code of Conduct.

    I understand that a criminal background check and residency verification will be conducted. If there is anything that is found by the background check that disqualifies me, I understand that I will not be able to coach. If there is any discrepancy found on the application or by the agency performing the background check, I will not be able to coach, even if I already have a team. 

25. Electronic Signature Agreement*

    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.

    1. I agree.
27. Electronic Signature*
29. Date*
31. League*
33. Age Group*
35. Ogden City Human Resources

    To ensure the accuracy of volunteer information, Ogden City has developed this form to make sure that our records have the most current information.

    If you have any health considerations that you’d like us to be aware of in the event of an emergency, please contact Heidi Olmedo/HR X8737. This information will be kept in a confidential file separate from your employee record.

37. Last Name*
38. First Name*
40. Middle/ Nick*
42. Home Address*
44. Mailing (if different from above)
46. City*
47. State*
48. Zip Code*
50. Phone Number*
51. Home Phone
53. Email*
55. Emergency Contact:
57. Name*
59. Relationship*
61. Phone*
63. Secondary Emergency Contact:
65. Name*
67. Relationship*
69. Phone*
Leave This Blank:


71. 1. Receive an email copy of this form.
72. Email address

    This field is not part of the form submission.

73. Submit

* indicates a required field