Cheer Athletics Charlotte Parent Compliance Tracking

I'd like to volunteer for the following youth-serving organization:

Which sport/activity does this company provide services in?

Company Name *

Company Address (include city and state) *

Company Phone Number *

Name and Contact Information

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

First

Middle

Last

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Email *

Cell/Mobile Number *

please ensure this number is able to receive text messages

Date of Birth *

Your Emergency Contact

In the event of an emergency whom should we notify?

Emergency Contact Name *

First

Last

Emergency Contact Address *

Address Line 1

Address Line 2

City

State

Zip Code

Emergency Contact Phone *

Emergency Contact Relationship *

spouse, family friend, neighbor, etc.

About You

Special professional training, skills, hobbies: *

Community affiliations (Clubs, Service Organizations, etc.): *

Previous volunteer experience- include the year: *

Do you have children in the program? *

YES
NO

If yes, list full name and what team(s), and what level?

Special Certification (CPR, Medical, etc.)? If yes, list:

Do you have a valid driver’s license? *

YES
NO

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.

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

YES
NO

Have you ever been convicted of or plead no contest or guilty to any crime(s)? *

YES
NO

(Answering yes to this, does not automatically disqualify you as a volunteer.)

Do you have any criminal charges pending against you regarding any crime(s)? *

YES
NO

(Answering yes to this, does not automatically disqualify you as a volunteer.)

Have you ever been refused participation in any other youth programs and/or listed on any youth organization ineligible list? *

YES
NO

(If volunteer answered yes to this, the local youth-serving organization must contact your Sports Compliance Company Risk Manager.)

Please list three references, at least one of which has knowledge of your participation as a 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? 1. 2. 3.

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

AS A CONDITION OF VOLUNTEERING, I give permission for The Sports Compliance Company or their customer/youth-serving organization to conduct background check(s) on me now and as long as I continue to be active with the organization, which may include a review of sex offender registries (some of which contain name only searches which may result in a report being generated that may or may not be me), child abuse and criminal history records. I understand that, if appointed, my position is conditional upon The Sports Compliance Company receiving no inappropriate information on my background. I hereby release and agree to hold harmless from liability the The Sports Compliance Company, their affiliates, customers, contractors, the officers, employees and volunteers thereof, or any other person or organization that may provide such information. I also understand that, regardless of previous appointments, The Sports Compliance Company is not obligated to appoint me to a volunteer position. If appointed, I understand that, prior to the expiration of my term, I am subject to suspension and removal for violation of The Sports Compliance Company policies or principles.

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.

SIGNATURE- Type Name (as it appears on your ID) *

You acknowledge and agree that this application may be executed by electronic signature, which shall be considered as an original signature for all purposes and shall have the same force and effect as an original signature. Without limitation, “electronic signature” shall include faxed versions of an original signature or electronically scanned and transmitted versions (e.g., via pdf) of an original signature.

FOR RISK MANAGER 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- JDP (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 JDP and there is a name match in the few states where only name match searches can be performed you should notify volunteers that they will receive a letter or email directly from JDP 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 league volunteer. Only attach to this application copies of background check reports that reveal convictions of this application.