Tier 1 Volunteer Application

Tier 1 Volunteer Application

Bridge II Sports is a community-based sports, recreation, and physical activity program for youth and adults with physical disabilities. Bridge II Sports programs and services encourage healthy lifestyles, foster independence and inclusion, and promote personal empowerment.

A copy of a valid government issued photo identification must be attached and used to verify information below.

Name Date of Birth

Phone # Email Address

Address

City State Zip

Occupation Employer

Do you have a valid driver’s license? ⎕ Yes ⎕No ______

Driver’s License # Issuing State

Do you have a current CDL endorsement? ⎕ Yes ⎕No ______

Endorsement Issuing State

Do you have any experience in adapted sports? ______

If yes, please explain: ______

______

Special professional training, skills, hobbies: ______

______

Community Affiliations: ______

______

Previous Volunteer Experience: ______

______

Special Certifications (i.e. CPR, Medical Aid Certified, etc): ______

______

Are any of your relatives active athletes with Bridge II Sports? ⎕ Yes ⎕No

If yes, please list their names and sports associated: ______

______

Have you ever been convicted of or plead guilty to any crime(s), including sex-related or child-abuse offenses: ⎕ Yes ⎕No

If yes, describe each in full: ______

______

______

Have you ever been refused participation in any other youth programs? ⎕ Yes ⎕No ______

______

Why would you like to volunteer for Bridge II Sports? ______

______

For which event(s) or program(s) would you like to coach/volunteer/drive the bus?

Programs ⎕ Air Rifle ⎕ Archery ⎕ Boccia (Chapel Hill) ⎕ Boccia (Cary) ⎕ Cycling ⎕ Dragons ⎕ Fishing ⎕Golf ⎕ Goalball ⎕ Jr. Thunder ⎕ Track & Field ⎕ Kayaking ⎕ School Initiative

Events ⎕ August Madness ⎕ Valor Games SE ⎕ Paddle! Lake Crabtree

⎕ Hog Wild (WCB) ⎕ Carolina Winter Classic ⎕ Tournaments

Please list two references:

Name Title Relationship

Telephone Number Email Address

Name Title Relationship

Telephone Number Email Address

As a condition of volunteering, I give permission to Bridge II Sports to conduct a background check on me, which will include a review of sex offender registries, child abuse, and criminal history records. I understand that, if appointed, my position is conditional upon Bridge II Sports receiving no inappropriate information on my background. I hereby release and agree to hold harmless from liability Bridge II Sports organization, Incorporated, the officers, employees, and volunteers thereof, or any persons of the organization that may provide such information. I also understand that, regardless of previous appointments, Bridge II Sports is not obligated to appoint me to a volunteer position. If appointed, I understand that, prior to the expiration of my terms; I am subject to suspension by the Program Manager and removal by the Executive Director for violation of Bridge II Sports policies or principles.

Applicant Name (please print) Date

Applicant Signature

Note: Bridge II Sports will not discriminate against any person on the basis of race, creed, color, national origin, marital status, gender, sexual orientation, or disability.

You can email, mail, fax, or drop off at:

3729 Murphey School Rd.

Durham, NC 27705

Phone/Fax: 866-880-2742

Email:

Applicant’s Name: