MANAGER Application and Consent for Background Check - Spring 2019

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Granbury Athletic Association Fall 2019 Manager Registration / Background Check Form
*Please note, this application is only for those who wish to be the MANAGER (or head coach) of a team.  If you have any questions about the requirements / responsibilities of being a manager please contact us at info@granburyathletic.com BEFORE completing this form.
Applicant Information
*First Name
*Last Name
Maiden Name (if applicable)
Other Name(s)
you have used as an adult
*Street Address
*City
Don't type in this field
*State
*Zip Code
*Email
*Daytime Phone
Evening Phone
Mobile Phone
*Birthdate
*Drivers License Number
*Drivers License State
Division
*Select the Division you desire to coach
Experience
*Did you coach in the Spring '18 season?
*Did you coach in the Fall '17 season?
If you have not previously coached with GAA, briefly list your coaching experience.
Explanation 1
Arrest and Conviction Record
Have you ever been convicted of a felony involving harm to a child or minor in any way?
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Have you ever been convicted of a felony or misdemeanor involving improper conduct with, towards, or around a minor?
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Agreement/ Authorization
Do you agree to abide by all of the following:
-Abide by all the rules of Granbury Athletic Association  ("GAA")
-To conduct myself in both speech and action in a manner that will be a positive influence on the players and will be beneficial to GAA and the community
-To do my utmost to teach sportmanship, leadership, fair play and citizenship
-In addition to coaching, I agree to recruit volunteers to work in the concession stand and to work as score keepers.  I also agree to actively support fund raising activities of GAA, including a goal of raising one (1) $300 sponsorship banner for my team.
- If for any reason, my behaviors are deemed by the Granbury Athletic Association Board to be "not in the best interest" of the league, I will be required to end my status with the league.
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Background Check Authorization
I hereby give my permission for Granbury Athletic Association to obtain information related to my background, including any criminal history record through Publicdata.com.  The criminal history record, as received from the reporting agencies, may include arrest and conviction data as well, as plea bargains and deferred adjudications.  I understand that this information will be used in part to determine my eligibility for an employee or volunteer position with Granbury Athletic Association.  I also understand that as long as I remain an employee or volunteer with Granbury Athletic Association that the criminal history records check may be repeated at any time.  In the event that I dispute the record as received, I understand that I will have an opportunity to review the criminal history information with Granbury Athletic Association and have an opportunity to clarify the information.
I, the undersigned, do, for myself, my heirs, executors and administrators, hereby remise, release, and forever discharge and agree to indemnify and hold harmless Granbury Athletic Association, each of their officers, Board members, causes of actions, suits, liabilities, costs, debts, and sums of money, claims and demands whatsoever, and any and all related attorneys' fees, court costs, and other expenses resulting from the investigation of my background in connection with my application to become an employee or volunteer with Granbury Athletic Association.
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By agreeing below, I consent that all the information provided in this form is true and correct, and that this shall serve as my electronic signature.
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