Requirements for Volunteer Club Coaches

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Amelia Wilkerson
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University of California, Irvine Campus Recreation CLUB SPORTS COACH AGREEMENT THE FOLLOWING ITEMS MUST BE COMPLETED TO BECOME AN APPROVED VOLUNTEER CLUB COACH.

1 University of California, Irvine Campus Recreation CLUB SPORTS COACH AGREEMENT THE FOLLOWING ITEMS MUST BE COMPLETED TO BECOME AN APPROVED VOLUNTEER CLUB COACH. Requirements for Volunteer Club Coaches Read and complete all sections of the Volunteer Club Coach Agreement Form. o Fill out Volunteer Club Coach Agreement o Complete the bottom half of the Volunteer Record o Sign the Liability Waiver o Initial and sign the Club Coach Code of Conduct sheet. Attach a copy of your coaching resume. Submit a signed Mandated Reporter Form (Statement Acknowledging Requirement to Report Child Abuse) Complete the following online training requirements: o Heads Up Concussion: o Mandated Report Trainings: (see instructions in the club sport handbook) Complete: California Mandated Reporter Complete: Abuse Risk Management for Volunteers Completion Certificate of Heads Up Concussion Training Screenshot of Completion of California Mandated Reporter & Abuse Risk Management for Volunteers Requirements for Club Sport Program Administration Provide Club Coach Handbook to volunteer club coach Explain steps to complete required trainings Provide Mandated Reporter Information Sheet Review documents for accuracy/completion. Meet with club coach to discuss club policies after submission of a complete application.

2 VOLUNTEER CLUB COACH AGREEMENT PLEASE PRINT LEGIBLY Name of Sport Club: Year: Name of Coach: Home Address: Cell Phone #: Address: Coach Compensation Volunteer Paid (rate) $ per quarter/year/ *Earned Salary is paid from money raised by the club. All income earned must be reported for tax purposes. Qualifications: (Attach resume) Please list qualifications and experiences relating to coaching this activity: References: Please list three (Name, position, phone #): I understand that I am not considered an employee of the University of California and I am not covered under the University s insurance or workers compensation program. I also certify that I carry my own medical and health insurance coverage. It is also recommended that Club Sports coaches carry personal liability insurance coverage. As a volunteer, any expenses that I incur as a Club Sports coach are not eligible for reimbursement. I have read and understand the responsibilities and obligations of serving as a Club Sports Coach listed in the Club Sports Handbook (a copy is attached to this form). I agree to fulfill those duties and serve in the best interests of the Club and the Club Sports program. Signature Date (please read and complete the waiver agreement on the reverse side) Club President Approval (Signature & Date) Club Sports Director Approval (Signature & Date)

3 VOLUNTEER RECORD (To be completed by the University and maintained in the Department) Department Name: Campus Recreation Volunteer Name: Assignment Beginning Date: End Date: Description of services to be rendered on a volunteer basis*: Provide instruction and guidance to members of the club sport at UC Irvine. Name of supervisor for activities: Volunteer Schedule: Monday Tuesday Wednesday Thursday Friday Saturday Sunday Location where volunteer assignment will be performed: [x] Campus [ ] Medical Center [ ] Other Building Name and room number: (please give specific information) (To be completed by the volunteer) Name: Address: Home Phone: Work Phone: Cell Phone: Address: In case of emergency, contact: Name: Relationship to volunteer: Cell Phone: The volunteer service described above will be uncompensated. I understand that either the University or I may discontinue the volunteer service at any time without notice. I agree to abide by the rules and policies of the University. Volunteer Signature University Representative Signature & Title Date Date *Services should not include contact with human blood, body fluid or tissue, radioactive compounds or hazardous chemicals without prior consultation with Environmental Health and Safety to ensure the volunteer has the appropriate training, vaccinations and health coverage.

4 Participant s Name: Please Print UNIVERSITY OF CALIFORNIA, IRVINE Campus Recreation and Anteater Recreation Center Club Sport Coach / Advisor Waiver Waiver of Liability, Assumption of Risk, and Indemnity Agreement Waiver: In consideration of being permitted to participate in any way in Campus Recreation or Anteater Recreation Center Programs. Including but not limited to coaching, instructing, or advising Club Sport teams or programs, participating in Club practices, Activity Classes, Special Events, or Drop-in Activities, hereinafter called The Activity, I, for myself, my heirs, personal representatives or assigns, do hereby release, waive, discharge, and covenant not to sue The Regents of the University of California, its officers, employees, and agents from liability from any and all claims including the negligence of The Regents of the University of California, its officers, employees and agents, resulting in personal injury, accidents or illnesses (including death), and property loss arising from, but not limited to, participation in The Activity. Signature of Parent/Guardian of Minor Date Signature of Participant Date Assumption of Risks: Participation in The Activity carries with it certain inherent risks that cannot be eliminated regardless of the care taken to avoid injuries. The specific risks vary from one activity to another, but the risks range from 1) minor injuries such as scratches, bruises, and sprains to 2) major injuries such as eye injury or loss of sight, joint or back injuries, heart attacks, and concussions to 3) catastrophic injuries including paralysis and death. I have read the previous paragraphs and I know, understand, and appreciate these and other risks that are inherent in The Activity. I hereby assert that my participation is voluntary and that I knowingly assume all such risks. Indemnification and Hold Harmless: I also agree to INDEMNIFY AND HOLD The Regents of the University of California HARMLESS from any and all claims, actions, suits, procedures, costs, expenses, damages and liabilities, including attorney s fees brought as a result of my involvement in The Activity and to reimburse them for any such expenses incurred. Severability: The undersigned further expressly agrees that the foregoing waiver and assumption of risks agreement is intended to be as broad and inclusive as is permitted by the law of the State of California and that if any portion thereof is held invalid, it is agreed that the balance shall, notwithstanding, continue in full legal force and effect. Acknowledgment of Understanding: I have read this waiver of liability, assumption of risk, and indemnity agreement, fully understand its terms, and understand that I am giving up substantial rights, including my right to sue. I acknowledge that I am signing the agreement freely and voluntarily, and intend by my signature to be a complete and unconditional release of all liability to the greatest extent allowed by law. Signature of Parent/Guardian of Minor Date Signature of Participant Date Participants Age (if minor) Volwaiver 5/01

5 UCI Club Sport Coach s Code of Conduct *Please acknowledge the following statements by initialing each.* Promoting Student Athlete Well-Being or Responsibilities to Student Athletes I accept that student s academic responsibilities supersede all athletic responsibilities. (College Degree FIRST, and athletics SECOND) I will assure all injuries are reported in a timely manner to the Competitive Sports Office. I will not physically, mentally or psychologically haze anyone, as I respect the dignity of all persons. Actions of the team or me will never deliberately jeopardize the safety and well-being of opponents, teammates, officials or spectators. I will not engage in sexual harassment: solicitation, physical advances or verbal/nonverbal conduct that is sexual in nature and is unwelcomed, offensive or creates a hostile environment. I will not engage in discrimination based on age, gender, race, ethnicity, national origin, sexual orientation, disability, language, socioeconomic status or any basis prescribed by law. Sportsmanship I accept the notion that an athlete's strong desire to compete and succeed is in no way compromised by respect for the rules and opposing teams. I respect the authority of all game officials. I shall treat all game officials in a professional and courteous manner at all times. I shall neither exhibit nor tolerate any behavior from others (staff and team) - verbal or otherwise - that is disrespectful to an official or an opposing team/coach. I understand that is my responsibility, as the coach, to address unsportsmanlike behavior and put an end to it. I shall constantly be alert to ensure that my team is conducting and promoting themselves properly. I will never teach my players tactics or skills designed to circumvent the intent of the rulebook and the standards of fair play. Upholding Department/University Policies I accept that participation in Club Sports is an opportunity and a privilege, not a right. I will adhere to the rules established by the University of California, Los Angeles, Cultural and Recreational Activities and the Competitive Sports Office. I understand that the presence and consumption of alcohol and/or illegal substances is strictly prohibited during any sport club activity unless approved by the Director of Competitive Sports and UCPD. Sport club activity includes games, practices, travel and any activity before and during sport club activity and any related activity reasonably perceived to be a club sport activity. Violation of this policy could result in probation, suspension and/or expulsion of the individual and/or club from the Club Sport Program. I shall never interfere with the duties and jurisdiction of other departments of an institution, including but not limited to admissions, compliance and the various academic disciplines.

6 Upholding Department/University Policies (continued) I understand that I am designated as a Clery Act Campus Security Authority (CSA) and will use the Campus Security Authority Crime Report form for each incident reported to me as they are reported as outlined in the Clery Act. Additional information can be found: I understand that I am a CANRA mandated reporter and I am responsible for reporting crimes against children or dependent adults and elders to law enforcement or social services authorities. I agree to remove any athlete demonstrating signs or symptoms of a concussion from physical activity immediately and require the athlete to be evaluated by a qualified medical professional (certified athletic trainer, etc.). A graduated return to activity program will be followed after getting clearance from a medical professional. I have read and understand all policies outlined in the club coach handbook. I agree to comply with all club sport policies. Professionalism I understand that my actions, positive or negative, are representative of UCLA, Cultural and Recreational Activities, and the Competitive Sports Office. I will practice good sportsmanship at all practices, scrimmages, and games, win or lose. I will conduct myself to maintain the highest principles, integrity, and dignity of UCLA, Club Sports and my sport. I will expect the same of my team on and off the field. I understand that my position requires leadership skills that must encourage full participation in meeting the goals of the club and its members. I will do all in my power to see that practice, scrimmage and game sites are clean after use, both of trash and Equipment, and thus maintained for future events. I am responsible for myself and my team knowing, understanding and following all rules of the game as established and directed by the conference in which my team participates. I will report any personal relationships that can impact the team (ex. niece/nephew is on the team). By signing below, I agree to have fully read and understand the contents of this policy. I understand the expectations set forth by this policy and will uphold said expectations at all times during my enrollment/employment as a Coach of a Club Sport team. Adherence of coaches to a code of conduct is largely a voluntary matter. However, if a coach does not follow this code by engaging in gross misconduct, their relationship with the UCI Club Sport Program may be terminated. Understand your signature confirms your willingness to work within the guidelines of the Club Sports Program. Coach Signature Club Date

ANTEATER RECREATION SUMMER CAMP

ANTEATER RECREATION SUMMER CAMP COMPLETING YOUR WAIVER FORMS All forms have the ability to be completed through Adobe Acrobat. At this time, the University still requires inked (not electronic) signatures.