New Adult Registration | Screening Request - The Sports Compliance Company

Your Name (as on your state-issued ID) (copy) *

First

Middle

Last

Cell/Mobile Number *

please ensure this number is able to receive text messages

Email *

Date of Birth *

Current Address *

Address Line 1

Address Line 2

City

State

Zip Code

Headshot Upload *

Click or drag a file to this area to upload.

Upload headshot- (professional in nature, shoulders up, must show clothes/ shirt)

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Information about the company you're requesting access to:

Company Name *

Company Address (include city and state) *

Company Phone Number *

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Your Information, ensure either Option A OR B are provided.

Option A. Upload your CV/resume here. Must include complete history. If you do not have a resume, you can type in your team and work history below.

Click or drag a file to this area to upload.

Option B. Previous experience in youth-serving activities, either as a coach or a participant

format for each: Year Rostered, Company (ie: XYZ Gymnastics), Team Name, Coach Names, List Two References From Each Team

Please list three references, at least one of which has knowledge of your participation as a participant/coach/volunteer in a youth program. Include their full name, address, cell phone, email address, and number of years known. *

FORMAT: Full Name, Address, City, State, Zip, Phone, Email, How Many Years Known?

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Have you completed background screening prior to today? An example would be screening through organizations like Boy Scouts of America, Boys and Girls Club, or any sports league or sports federation.

Do you have any current background screening clearances that grant participation in youth sports? *

YES
NO

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Who do we contact in case of emergency?

In the event of an emergency whom should we notify? This can not be anyone you currently reside.

Emergency Contact Name *

First

Last

Emergency Contact Phone *

Emergency Contact Relationship *

spouse, family friend, neighbor, etc.

Emergency Contact Address *

Address Line 1

Address Line 2

City

State

Zip Code

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Potential Participation with Juvenile Athletes

We provide screening services to adults requesting access to facilities that provide youth sports and recreational activities. All answered are used solely to ensure we are meeting local, state, federal and sport federation requirements.

Have you ever been charged with, convicted of, plead no contest, or guilty to any crime(s) involving or against an animal, a child, or of a sexual nature? *

YES
NO

Have you ever been convicted of or plead no contest or guilty to any crime(s) in the last 7 years that would not satisfy the USOPC background screening requirement? The following criterion offenses are below in grey. *

YES
NO

Answering yes to this does not automatically disqualify you. Background Screening Criterion Offenses Any felony; and Any misdemeanor involving: All sexual crimes, criminal offenses of a sexual nature to include but not limited to; rape, child molestation, sexual battery, lewd conduct, possession and distribution of child pornography, possession and distribution of obscene material, prostitution, indecent exposure, public indecency, and any sex offender registrant; Any drug-related offenses; Harm to a minor, including, but not limited to, offenses such as child abandonment, child endangerment/neglect/abuse, contributing to the delinquency of a minor, and DUI with a minor; Violence against a person, force, or threat of force (including crimes involving deadly weapons and domestic violence); Stalking, harassment, blackmail, violation of a protection order, and/or threats; Destruction of property, including arson, vandalism, and criminal mischief; and Animal abuse, cruelty, or neglect. Criminal offenses include "Attempted Crimes" in the above classifications.

Do you have any criminal charges pending against you regarding any crime(s) that would preclude your particpation based on the United States Olympic and Paralympic Committee criteria? *

YES
NO

Answering yes to this does not automatically disqualify you. See above for the criteria that is identified by the USOPC.

Have you ever been refused participation in any other youth programs? *

YES
NO

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The Sports Compliance Company will not discriminate against any person on the basis of race, creed, color, national origin, marital status, gender, sexual orientation or disability.

STATE OR FEDERALLY ISSUED IDENTIFICATION UPLOAD *

Click or drag files to this area to upload. You can upload up to 2 files.

upload two files- front and back of identification. Files must be under 10 MB.

As an adult requesting consideration to participate in a facility that primarily serves juvenile athletes, I acknowledge that I have read my sport governing body's rules, the rules and policies of the program I am requesting to participate with, and understand that there is to be zero one on one contact with any juvenile athlete at any time, both physically and electronically. If I am on a team with athletes who are minors I agree to not be in electronic conversations on any platform (Snapchat, Instagram, iMessage, etc) at any time.

I agree
I do not agree

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INTERNAL USE ONLY

Background check completed by risk officer _________________________ on _________________ (insert date) System(s) used for background check (minimum of one must be checked): Review all background check requirements- Background screening Includes review of the US. Center of SafeSport’s Centralized Disciplinary Database and Sport Ineligible List* National Criminal Database check National Sex Offender Registry U.S. Center of SafeSport’s Centralized Disciplinary Database and sport federation Ineligible List *Please be advised that if you use our services for screening and there is a name match in the few states where only name match searches can be performed you should notify submitter that they will receive a letter or email directly from our screening provider in compliance with the Fair Credit Reporting Act containing information regarding all the criminal records associated with the name, which may not necessarily be the person who submitted for screening. Only attach to this application copies of background check reports that reveal convictions of this application.

Rich Text

New Adult Registration | Screening Request

Information about the company you're requesting access to:

Your Information, ensure either Option A OR B are provided.

Have you completed background screening prior to today? An example would be screening through organizations like Boy Scouts of America, Boys and Girls Club, or any sports league or sports federation.

Who do we contact in case of emergency?

Potential Participation with Juvenile Athletes

The Sports Compliance Company will not discriminate against any person on the basis of race, creed, color, national origin, marital status, gender, sexual orientation or disability.

IF YOU LIVE IN A STATE THAT REQUIRES A SEPARATE BACKGROUND CHECK BY LAW, PLEASE ATTACH A COPY OF THAT STATE’S BACKGROUND CHECK. FOR MORE INFORMATION ON STATE LAWS, VISIT OUR WEBSITE: Sportscompliance.com/StateLaws

INTERNAL USE ONLY