American Canyon Patriots

Youth Football and Cheer, Inc.

Volunteer Application

Name:

Email Address

Position for which you are applying (i.e. head coach Midgets, assistant on which coach division, etc):

Position:

For Head Coach or Assistant Coach, please choose a division.

Division:

If the division position of your choice is not available, would you be open to another division? Yes No

Date of Birth	(mm/dd/yyyy)
Address
City State Zip
Home Phone
Work Phone

Name(s), Age(s), & Activity Of Children in Pop Warner/AC Patriots:

Name	Age	Activity

Have you been convicted of any felony? Yes No
If yes, please provide details below.

Please state in detail your prior experience that would benefit and assist you in performing your duties and activities for which this application is made:

I hereby swear and attest that all information provided on this application is true and complete to the fullest extent of my knowledge. If I am accepted as a volunteer, ACPYFC may end the relationship if I have made any false statements or material misrepresentations, written or verbal. As a condition of volunteering, I hereby grant permission to ACPYFC to conduct a background check on me, which may include a review of database records including but not limited to sex offender registries, child abuse and criminal history records. I understand and agree that, if appointed, my position is conditional upon the league receiving no inappropriate information on my background. I hereby release and agree to hold harmless from liability ACPYFC, the officers, employees and volunteers thereof, and/or any other person or organization that may provide such information.

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