Raceland-Worthington Youth Baseball - Coaching Background Information

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2024 Season

Name *

Date Of Birth *

YYYY

Mailing Address *

Phone Number *

Email Address *

Driver's License State *

Driver's License Number *

Division *

I the undersigned, authorize this information to be obtained either in writing or via telephone in connection with my application. Any person, firm or organization providing information or records in accordance with this authorization is released from any and all claims of liability for compliance. Such information will be held in confidence in accordance with the organization’s guidelines. By selecting YES I am providing Raceland Worthington Youth Baseball Association my consent for an initial background check as well as any subsequent background checks deemed necessary throughout the length of my involvement with the organization.
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