Basketball Coaching Application

* Required Fields
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By filling out and signing this form, you understand that the Ocean Springs Parks and Recreation Department reserves the right to contact your employer, obtain any criminal history, and conduct a full background check by any means necessary. 

Sports Information

*Final age divisions will be contingent on registration numbers. 

*Desired Role/ Position
 Head Coach 
 Assistant Coach 
Girls Winter Basketball 
Girls Winter 5-6
  
Girls Winter 7-8
  
Girls Winter 9-12
  
Boys Winter Basketball 
Boys Winter 5-6
  
Boys Winter 7-8
  
Boys Winter 9-10
  
Boys Winter11-12
  
Girls Spring Basketball 
Girls Spring 9-12
  
Girls Spring 13-16
  
Boys Spring Basketball 
Boys Spring 9-10
  
Boys Spring 11-12
  
Boys Spring 13-14
  
Boys Spring 15-16
  
If you are registering your child(ren), please list their name(s) below so we can add them to your team.
Child(ren)’s Name(s):
If you have a coaching partner, please list their name below.
Head Coaches and First Assistant Coaches will have their child (if applicable) placed on their team as a benefit of their role. Thank you for volunteering to coach!
Coaching Partner:

Personal Information

*Name- First
*Name- Last
*Date of Birth (MM/DD/YYYY)
Don't type in this field
SSN
*Driver License Number
*State of issuance:
*Address
*City
*State
*Zip Code
*Primary Phone Number
*Email Address

Coaching Experience

*Have you coached youth sports before?
 Yes 
 No 
*List all organizations you have coached with

Police Record
Have you been arrested for, charged with, or convicted of any offense as an adult?
*Record
 Yes 
 No 
If yes, please explain.

Applicant Acknowledgments and Digital Signatures

The mission of the Ocean Springs Parks and Recreation department is to provide a fun, recreational, and learning environment in which children can learn the fundamentals of sports, and acquire experience in good sportsmanship, honesty, team unity, and respect. The league is designed with each child's best interest in mind and will not tolerate any acts of aggression, irresponsibility or any other type of abuse or bad sportsmanship by players, parents, or coaches.

I fully understand and agree to abide by the mission and procedures of the Ocean Springs Parks and Recreation department at all times while engaged in any event involved with the youth sports league. 

*Electronic Signature
 Select yes to indicate agreement. 

Having made application for head / assistant coach with the City of Ocean Springs Parks and Recreation department, I hereby authorize the City to research and make inquiry of my history and records including academic, military, employment, judicial, criminal, driving record, personal references, and/ or online social networking pages. I further authorize the release of all such information to the city and I agree that such organization persons and others shall not be held liable for such information or damages that may result from furnishing the information requested. I understand my rights under the act of 1974, with regard to access and disclosure of records, and I waive these rights with the understanding that information furnished will be used by the city of Ocean Springs.

This authorization will be valid whether as an original, photocopy, or fax copy and remains valid for one year after I sign. Upon request, a copy of this signed authorization may be furnished to the school, present, or former employer criminal justice agency or other persons and organizations asked to provide information.

*Electronic Signature
 Select yes to indicate agreement. 
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Ocean Springs Parks & Recreation
Ocean Springs, MS 39564
228-875-8665