Grace Church Upward Basketball Volunteer Application

Applicant Information (* Indicates required field)

I would like to: *

COACH Upward Basketball

REFEREE Upward Basketball

First Name *

Last Name *

Sex *

Male

Female

Street Address *

Address Line 2

City *

Zip Code *

Primary Phone Number (Prefer Mobile) *

May we send you text messages? *

Mobile Service Provider *

Please Specify *

E-mail Address (Must be reliable and regularly checked as we use this often) *

Birth Year *

Assess your basketball knowledge *

Shirt Size *

Shirt Type *

Polo

T-Shirt

Do you regularly attend a local church? *

Yes

No

If yes, where? *

Please indicate which division(s) you wish to coach and/or referee.

	Coach	Referee
1st/2nd Boys	Coach	Referee
3rd/4th Boys	Coach	Referee
5th/6th Boys	Coach	Referee
1st/2nd Girls	Coach	Referee
3rd/4th Girls	Coach	Referee
5th/6th Girls	Coach	Referee
No Preference	Coach	Referee

Which time slot(s) on Saturday do you prefer to Referee? (Younger children play earlier games) *

Are you willing to referee a full court game? *

Yes

No

List your children that are in Upward (if applicable). This does NOT register your child for Upward.

	Child Name	Grade in School	Sex (Male/Female)	Want to Coach (Y/N)
Child 1	Child Name	Grade in School	Sex (Male/Female)	Want to Coach (Y/N)
Child 2	Child Name	Grade in School	Sex (Male/Female)	Want to Coach (Y/N)
Child 3	Child Name	Grade in School	Sex (Male/Female)	Want to Coach (Y/N)

Have you coached Upward basketball before? *

Yes

No

Have you refereed Upward basketball before? *

Yes

No

Have you accepted Jesus Christ as your personal Savior? *

Yes

No

Unsure

Please tell us about your current relationship with Jesus. *

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Practice Night Conflicts

**PLEASE READ CAREFULLY** Your team's 1-HOUR weekly practice time will be assigned based on the division you are coaching, your conflicts, and the conflicts of the other coaches in your division. Please select NO MORE THAN 10 day and time combinations that DO NOT work for your schedule. 🛈

	4:30-5:30 p.m.	5:00-6:00 p.m.	6:00-7:00 p.m.	6:30-7:30 p.m.	7:30-8:30 p.m.
Monday	4:30-5:30 p.m.	5:00-6:00 p.m.	6:00-7:00 p.m.	6:30-7:30 p.m.	7:30-8:30 p.m.
Tuesday	4:30-5:30 p.m.	5:00-6:00 p.m.	6:00-7:00 p.m.	6:30-7:30 p.m.	7:30-8:30 p.m.
Thursday	4:30-5:30 p.m.	5:00-6:00 p.m.	6:00-7:00 p.m.	6:30-7:30 p.m.	7:30-8:30 p.m.
Friday	4:30-5:30 p.m.	5:00-6:00 p.m.	6:00-7:00 p.m.	6:30-7:30 p.m.	7:30-8:30 p.m.

Are you able to practice from 4:30-5:30 p.m. on Wednesday? * 🛈

Yes

No

Preferred

Check here if you are FULLY AVAILABLE for all possible practice slots. 🛈

I have no scheduling conflicts with any of these options

Check here if you PREFER to have your practice at 4:30 p.m.

I prefer to practice from 4:30-5:30 p.m.

Check here if you PREFER to have your practice on FRIDAY.

I prefer to practice on Friday

Check here to confirm you marked slots when you CANNOT practice. * 🛈

Yes, I marked my CONFLICTS in the table above

8 a.m. - Noon	10 a.m. - 2 p.m.	Noon - 4 p.m.	2 p.m. - 7 p.m.
No Preference