Community Volunteers Volunteer Registration Form 2022-2023 Season Volunteer – First and Last Name * Date of Birth * Address * Sex * Male Female Other Phone Number * Email * Previous Coaching Experience? * Where would you like to volunteer? * Small Ball U10 Boys U10 Girls U12 Boys U12 Girls U14 Boys U14 Girls U16 Boys U16/18 Girls U18 Boys Which position are you willing to fill? Head Coach Assistant Coach Team Manager Any of the above Liability Clause: PARENTS/GAURDIANS * Accept Decline I hereby release Express Basketball Association, its executive, coaches, agents and volunteers from any and all responsibility whatsoever for death or injury to myself whether caused by negligence or otherwise while playing basketball (indoor or outdoor) or being transported to or from a basketball game or practice. Covid19 Protocols * Accept Decline I understand that in addition to coaching duties, I will be responsible to follow all outlined Covid19 protocols as directed by the Club Executive. Coach Screening Policy * Accept Decline I understand and will complete the process of screening as outlined, but not limited to, Basketball Nova Scotia – Coach Screening Policy. Photograph/Video Consent: PARENTS/GAURDIANS * Accept Decline I understand that photographs/video taken of myself by a member of Express Basketball Association may be used by Express Basketball in the promotion and celebration of our youth basketball club, its athletes and/or coaches. What is your vaccination status? Fully Vaccinated Waiting for 2nd dose Not Vaccinated due to medical reasons Not Vaccinated Prefer not to disclose If you are human, leave this field blank. Submit
