Coaching Application
Philadelphia Little Flyers Coaching Application
Team Level Applying For: circle one
Squirt PeeWee Bantam Midget Junior
If you are not selected as a head coach, are you interested in being an assistant? Yes No
Are you currently coaching? Yes No
If yes, please state the team(s) and level(s) and your capacity (head coach, assistant coach, etc.)
Most recent active and valid coaching level certification ( circle only one)
Attach a copy of your coaching certification
Master Advanced Intermediate Associate
Previous Coaching Experience:
Name of child(ren) currently playing or planning to play ice hockey next season. Include birth year and
Level at which they are playing or plan to play.
References:
Briefly explain your coaching philosophy?
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Why do you want to coach with the Little Flyers?
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Have any complaints ever been made against you either at work or in your capacity as a volunteer that you sexually or physically abused a minor? Yes__ No__ If yes please explain.
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Philadelphia Little Flyers Coaching Application
Have you ever been subject to any court order involving any sexual abuse or physical abuse of a minor, including but not limited to a domestic order from protection? Yes__ No__ If yes, please explain
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Have you ever been adjudged liable for civil penalties or damages involving sexual or physical abuse?
Yes__ No__ If yes please explain.
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APPLICANT’S STATEMENT, AUTHORIZATION AND RELEASE OF LIABILTY
I certify that all the information given by me in this application is true and correct to the best of my knowledge. I understand that false or misleading statements made by me or consequential omissions of any kind in the application process, are sufficient cause for my not being accepted as a volunteer or for my dismissal, no matter when discovered.
I authorize The Philadelphia Little Flyers to investigate all information contained in this application. The individuals named are authorized to give you any and all information regarding my volunteer work, character, fitness and qualifications, including opinions, which they may about me.
In consideration of the evaluation of this application by the Philadelphia Little Flyers, I HEREBY WAIVE, RELEASE AND DISCHARGE The Philadelphia Little Flyers, all organizations and individuals and any other persons or entities from liability for all damages and losses of whatever kind or nature, except liability for willful intentions, acts or punitive damages, that may result from compliance or attempts to comply with this authorization.
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Signature
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Date
Coaching selections are subject to the Philadelphia Little Flyers Board of Directors approval. Please mail completed applications to the address below.
Philadelphia Little Flyers
827 Hunters Dr
Deptford, NJ 08096
Philadelphia Little Flyers Coaching Application
