Applicant Information

I would like to: *
Sex *
Do you regularly attend a local church? *
Please indicate which division(s) you wish to coach and/or referee.
1st/2nd Boys
3rd/4th Boys
5th/6th Boys
1st/2nd Girls
3rd/4th Girls
5th/6th Girls
No Preference
Which time slot on Saturday do you prefer to Referee? (Younger children play earlier games) *
List your children that are in Upward (if applicable). This does NOT register your child for Upward.
 Child NameGrade in SchoolSex (Male/Female)Want to Coach (Y/N)
Child 1
Child 2
Child 3
Have you coached Upward basketball before? *
Have you refereed Upward basketball before? *
Have you accepted Jesus Christ as your personal Savior? *
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Practice Night Exclusions

**PLEASE READ CAREFULLY** Your team's 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 6 day and time combinations that DO NOT work for your schedule. 🛈
 5:30 PM6:30 PM7:30 PM
Check here if you PREFER to have your practice on FRIDAY.
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