Chamber Baseball Application

Team to be managed or coached:
League or age group:
D.O.B.:
DL #:
State:
Last Name
First Name
Middle Initial
Sex
Race
Current Street Address
City
State/Province
Zip/Postal Code
Previous Home Address if above is less than five (5) years
Previous Street Address
Previous City
Previous State
Previous Zip
Occupation
Business Name
Business Address
Business City
Business State
Business Zip
Work Phone
Home Phone
Cell
Maiden  name or any other names used
PREVIOUS COACHING EXPERIENCE (IF OTHER THAN Chamber Baseball, Inc.)
League
City
Chamber Baseball COACHES CLINIC YEAR(s)

 

I have read and will abide by the rules set forth in the League rule book for the current year. I understand the uniforms and equipment purchased for this team are the property of the team and/or sponsor, and that I am solely responsible for the distribution, upkeep, and return of such to the League or sponsor for use in the following seasons. I also understand that all variances to the printed rules must be in writing from the League office. Any statement made by officers or employees of the league that are in conflict with the printed rule will not be considered unless confirmed in writing and signed by the League President. NOTE: I CERTIFY THAT I HAVE NEVER BEEN CONVICTED OF A CRIME (OTHER THAN TRAFFIC VIOLATIONS) AND BY MY SIGNATURE BELOW GIVE THE LEAGUE PERMISSION TO VERIFY ALL INFORMATION LISTED. **** ANY OMISSION REGARDING CONVICTIONS WILL BE GROUNDS FOR NON-ACCEPTANCE **** I hereby give my permission for the Chamber Baseball, Inc. to obtain information relating to my criminal history record. The criminal history record, as received from the reporting agencies, may include arrest and conviction data. I understand that this information will be used, in part, to determine my eligibility for an employment/volunteer position with this organization. A also understand that as long as I remain in employee or volunteer here, the criminal history record check may be repeated at any time. I understand that I will have an opportunity to review the criminal history and a procedure is available for clarification, if I dispute the record as received. I, the undersigned, do, for myself, my heirs, executors, and administrator, hereby remise, release, and forever discharge and agree to indemnify and hold the Chamber Baseball, Inc. officers, directors, employees, and agents harmless from and against any and all causes of action, suits, liabilities, cost, debt, and sums of money, claims and demands whatsoever, and any and all related attorney's fees, court costs, and other expenses resulting from the investigation of my background in connection with my application to become a volunteer/staff member.

If you have any convictions or criminal situations that keep you from agreeing to the above, please contact the office and let us attempt to assist you in being able to coach.  (972) 738-9900

Submission of this online forms indicates your agreement to all background checks and statements above.