Cannons Select Lacrosse Coaching Application
I authorize to make inquiry of or receive information from any person or organization regarding my suitability for coaching, and I do hereby give permission to any persons or organizations to provide such information.

I hereby forever waive, release, and covenant not to sue any person or organization, its agents and members, for the results of providing, obtaining, or acting upon such information. I give this waiver, release, and covenant not to sue for myself, my heirs, assigns, and successors in interest forever. I give this waiver, release, and covenant not to sue understanding that the information obtained may be such to disqualify me for the coaching position. I understand that such information is sought with confidentiality and I will not request copies of such information.

I also certify that all statements made on this application are true and complete, accurate and not misleading, to the best of my knowledge. I understand that any false statements, incomplete statements, or misrepresentations may subject me to immediate disqualification or dismissal. A copy of this authorization shall be effective as the original.

*Acceptance, retention, or review of this application does not guarantee a coaching position.

Today's Date *
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Last Name *
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First Name *
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Middle Name *
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Address *
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City *
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State *
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Zip *
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How long have you lived at this address? *
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If less than 3 years, please list previous address.
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Home Phone Number *
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Cell Phone Number *
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E-Mail Address *
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Drivers License # and State of Issue *
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Date of Birth *
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Active US Lacrosse Membership ID *
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Team Applying For *
Position Applying For *
Coaching Experience and Qualifications *
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Coaching Reference1 *
(Name, Phone, and Relationship)
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Coaching Reference2 *
(Name, Phone, and Relationship)
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Coaching Reference3
(Name, Phone, and Relationship)
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Have you been convicted of a criminal offense within the last 7 years? *
If so, please explain.
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Have you been charged with a criminal offense within the last 7 years or do you have a pending criminal charge against you? *
If yes, please explain
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Are you are required to register as a sex offender? *
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Use this space to share any information you would like us to have or explain any previous responses.
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Thank you for taking the time to complete this application. We will be in touch in the near future.
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