2021-22 Team Volunteer Application
Brockport Blizzard SC
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Name *
Date of Birth *
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Phone Number *
Address *
Position Requested *
Team Gender *
Age Group 2021-2022 *
Highest Level Coaching License *
Current CPR / First Aid Certification *
Risk Management Application Year *
Have you been ejected or otherwise disciplined for coaching or spectator conduct at a youth athletic event within the last year? *
If yes, please explain
Please indicate the highest level of soccer that you have competed *
List other coaching positions you have held that are relevant to the position for which you are applying. Please include other youth sports you have coached. (Note at what levels you've coached, how many years, and in which community/association). *
Provide a brief description of your main goals as a youth soccer coach and your coaching philosophy for youth athletics. *
Describe your strengths and weaknesses as a coach. *
Provide any additional background information or comments that you believe will aid the coach selection process. *
Please provide contact information for two references from teams for which you have coached in the past five years. The references should include one parent or player and at least one person responsible for hiring or supervising you as a coach (i.e. Athletic Director, Director of Coaching, or Travel Director). *
I understand that Brockport Soccer Club Background Check Policy requires all coaches, managers, board members and contractors to participate in a criminal background check process that may include submitting a fingerprint scan to a Livescan processing center and authorization for clearance with the NY Department of Justice database.   *
I understand that if I am accepted as Coach/Assistant Coach with Brockport Soccer Club, I would have to fulfill all of the coaches' expectations and attend all coaches' clinics and meetings. *
I understand that if I am selected as a Head Coach, I must obtain the age appropriate USSF Grassroots Coaching License by August of the upcoming year and will continue to obtain future Grassroots Coaching Licenses as my team progresses in age. Upon successful completion of the course(s), the club will reimburse you. If these licenses are not obtained, you will be ineligible to coach the season. *
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