Umpire Application
City of Ward Parks & Recreation
Email address *
Last Name, First Name & Middle Name *
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Jr/ Sr/ III/ IV
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All other names used
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Gender *
Phone number *
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Date of Birth *
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State of Birth *
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Race *
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Social Security Number *
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Driver's License Number & State *
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Address
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City
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Zip
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How many years have you umpired? *
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Certifications
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As an UMPIRE, I hereby acknowledge and abide by the rules and regulations of Ward Parks & Recreation. Failing to do so will result in being subject to dismissal from participating in any program associated with Ward Parks & Recreation. I give my consent for the Arkansas State Police to conduct a criminal record check on me & release the results to the City of Ward. I understand that I can challenge the completeness or accuracy of the Arkansas criminal history record by using the procedure set out in Title 28, CFR. 16.34. *
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