House League/Camp Volunteer Application – London Ramblers Basketball

Name*

First Last

Address*

Street Address City Postal

Cell #*

Email*

Birth Date*

Select coaching position from menu below:*

Are you willing to complete a police vulnerable sector verification to be able to volunteer/coach?*

Yes
No

**Cost of police vulnerable sector verification will be reimbursed by London Ramblers Basketball once we receive an original copy.** **A new VSV is required every 3 years.**

Please list any previous volunteer or coaching experience with youth. (If you have volunteered/coached with Ramblers previously no need to complete - state NR.)*

Concussion Policy*

I acknowledge having read, understood and agree to the concussion policy.

Click here to read the Concussion Policy

Volunteer Code of Conduct*

I acknowledge having read, understood and agree to adhere to the volunteer code of conduct.

Click here to read the Volunteer Code of Conduct & Guidelines

List 2 references of which at least one has knowledge of your participation as a volunteer in a youth program. (If you have volunteered/coached with Ramblers previously no need to complete- state NR.)

Name

First Last

Phone# and/or email

Name

First Last

Phone# and/or email

Coaches/Volunteer Signature*

First Last

I confirm all information above is true and up to date.