I want to coach

If you are interested in coaching and helping Westlake NJB transform the culture of youth sports to give all young athletes the opportunity for a positive, character-building experience.  Please fill out the Coaches Application below and copy and click here to email it!.

1. Name:____________________________________________________ Age:____________ DOB: ___________________
2. Address:__________________________________________________ City/Zip__________________________________
3. Telephone (Home):______________________________________ (Work):______________________________________
4. E-Mail:________________________________________________
5. Number of years in this community:__________
6. Did you Coach last season? Yes / No
If Yes, what Division:________________________________ Team:____________________________________
7. Names and ages of children planning to play in NJB:
____________________________________________________________________________________________
8. Name of two current active NJB or community members for use as a reference.
Name:______________________________________________ Phone:___________________________________
Name:______________________________________________ Phone:___________________________________
9. Please list the age division(s) in which you would be willing to coach or assistant coach in.
Division:______________________
Division:______________________
10. List your basketball experience.
__________________________________________________________________________________________________________
__________________________________________________________________________________________________________
12. What is your philosophy about coaching basketball?
__________________________________________________________________________________________________________
__________________________________________________________________________________________________________
13. If appointed as a coach or an assistant coach in NJB, I agree to the following two areas of interest and understand that if I do
not comply fully with any of the following requirements I may be removed as a coach. Please initial each item.
A) -Teaching baseball and setting a good example on and off the field _____
-Attend the NJB Coaches Clinic _____
-Help players attain the individual and team goals set forth by NJB _____
-Fostering a positive environment for players, parents, officials and
Volunteers, so that everyone in NJB can enjoy Basketball _____
B) Performing the administrative tasks necessary for the League to operate smoothly. Many of these
Duties can be delegated to parents, but they are all the responsibility of the coach. They include:
Find a team sponsor _____
Have your team on time for picture day _____
Help to spread the word and participate in fundraisers _____
Cleaning up the Gym as required _____
14. Have you ever been convicted of any crime(s)? Yes / No
If Yes, Explain: ___________________________________________________________________________________________
________________________________________________________________________________________________________
15. Have you ever been convicted of a crime against or involving a minor? Yes / No
If Yes, Explain:___________________________________________________________________________________________
________________________________________________________________________________________________________
16. Have you ever been refused participation in any other youth programs? Yes / No
If Yes, Explain:___________________________________________________________________________________________
________________________________________________________________________________________________________
I give permission for NJB to conduct a background check on me, which may include a review of criminal and child abuse records
maintained by governmental agencies. I understand that if appointed, my position is conditional upon NJB receiving no
inappropriate information on my background. I hereby release and agree to hold harmless from liability NJB, the officers,
employees and volunteers thereof, or any other person(s) or organization(s) that may provide such information. I also understand that
regardless of previous appointments I may not be appointed to a volunteer coach or assistant coach position. If appointed I understand
that, prior to the expiration of my term, I am subject to suspension by the President and removal by the Board of Directors.
Signed:___________________________________________________________________ Date:_____________
Print Name__________________________________________________________________________________
Westlake NJB will not discriminate against any person on the basis of race, creed, color, national origin,
marital status, sex or sexual orientation, or disability.