BASEBALL VOLUNTEER FORM
South Orange Maplewood Cal Ripken/Babe Ruth Baseball
Volunteer Name: ___________________________________________Date: ________________
Home Phone: _________________________Cell/Business Phone: ________________________
E:mail (print NEATLY): ___________________________________________________________
Player’s Name: ______________________________Player’s League Age (on April 30th): ______
Player’s League – Check appropriate box below.
____
T- Ball American (Age 5 on April 30th)
____
Minor League (Age 9 on April 30th)
____
T- Ball National (Age 6 on April 30th)
____
Majors 60 League (Ages 10-11 on April 30th)
____
Rookie American (Age 7 on April 30th)
____
Majors 70 League (Age 12 on April 30th)
____
Rookie National (Age 8 on April 30th)
____
Babe Ruth (Ages 13-15 on April 30th)
Please check the appropriate box/es below, indicating the position/s you would like to
volunteer for. A brief description of each appears on the back of this form.
____ HEAD COACH* for the spring recreation season
____ ASSISTANT COACH* for the spring recreation season
____ TEAM MANAGER
Coach/Assistant Coach volunteers - Please answer the questions below.
Have you coached baseball in So.Orange or Maplewood before? _____ If so, how many years? _____
Do you want to be paired with a specific coach? ______
If so, who? _______________________________________________________________________
Have you played any organized baseball above the High School Level? ________________________
If so, where? _______________________________________________________________________
* PLEASE NOTE: All volunteers wanting to serve as coach or assistant coach for the SOM Cal
Ripken/Babe Ruth Baseball program are required to complete the Rutgers S.A.F.E.T.Y. Course
(offered and paid for by South Orange Maplewood Baseball). Coaching volunteers in this program
must also complete a Coaching Application, authorizing a background check every 3 years.
Completing these forms does not guarantee placement.
Completed form must be returned to the S.O. Department of Recreation, Attention: Kate Schmidt
Page 1
VOLUNTEERS NEEDED!
The success of the South Orange Maplewood baseball program rests with the many
volunteers who help out in a variety of ways. During the spring baseball season, adult
volunteers are needed for all teams to serve as coaches, assistant coaches, team managers
and scorekeepers. We are also in need of coaching volunteers for our Summer Baseball
program. A brief description of each follows.
HEAD COACH for the spring recreation season – A Head Coach has the primary
responsibility of dealing with players and parents. He/she has final decision in all baseball
matters. Coaching volunteers are required to attend the Rutgers S.A.F.E.T.Y. Clinic, a
coaches' certification course. This course will be offered in South Orange in March (date
TBD) for all new coaches. Adults interested in volunteering as a Head Coach must complete
the Volunteer Form on the reverse side. All COACHES in the SOM Baseball program must
also complete a Coaching Application, consenting to a background check every 3
years.
ASSISTANT COACH for the spring recreation season – An Assistant Coach has the
responsibility of helping the Head Coach. Coaching volunteers are required to attend the
Rutgers S.A.F.E.T.Y. Clinic, a coaches' certification course. This course will be offered in
South Orange in March (date TBD) for all new coaches. Adults interested in volunteering as
an Assistant Coach must complete the Volunteer Form on the reverse side. All COACHES in
the SOM Baseball program must also complete a Coaching Application, consenting to
a background check every 3 years.
TEAM MANAGER – A Team Manager is a parent volunteer who assists the coach/es by
organizing and disseminating information to team parents regarding practices, games, etc.
Communication is done via telephone and e:mail. Team managers may also assist with
scorekeeping and pitch counts (for Minors, Majors and Babe Ruth). Adults interested in
volunteering as a Team Manager must complete the Volunteer Form on the reverse side.
QUESTIONS? Contact Kate Schmidt at the South Orange Department of Recreation &
Cultural Affairs, (973) 378-7754, ext. 1.
Page 2
Village of South Orange, Department of Recreation & Cultural Affairs
5 Mead Street, South Orange, New Jersey 07079
Phone: 973-378-7754, ext. 1 Fax: 973-378-7833
Coaching Application: Acknowledgement and Consent for Background Check
All coaches in the South Orange Maplewood Cal Ripken/Babe Ruth Baseball program must consent to a
background check every 3 years by completing the form below. To foster safety and security of the children
who participate in our recreation programs, it is the policy of the South Orange Department of Recreation &
Cultural Affairs to conduct criminal background screenings of all Recreation Department volunteer coaches.
Coaching applicants will only be screened for criminal convictions as detailed on the reverse side of this
form. If you wish to serve as a volunteer coach, you must execute the consent form to allow the Recreation
Department to conduct such searches. If you have ever been convicted or pled guilty to any of the crimes listed
on the reverse of this
Consent Form, you will be automatically disqualified from serving as a volunteer.
I, _________________________________ have read and hereby consent to allow South Orange Department
of Recreation & Cultural Affairs, through its employees, agent or third-parties retained by the Department, to
conduct a criminal background record search of me. I understand, acknowledge, and consent to the fact that
this search is a condition of my service as a volunteer. I also understand, acknowledge, and consent that if the
results of the search reveal a conviction of guilty plea to any of the crimes listed on the reverse side of this
consent form, I will be disqualified from serving as a volunteer coach.
I hereby release and agree to hold harmless the Township of South Orange, the South Orange Department of
Recreation & Cultural Affairs, its agents, employees or other third party, and/or any other person or organization
that may provide information.
I also understand that, regardless of previous appointments as a volunteer coach, the South Orange
Department of Recreation & Cultural Affairs is not obligated to appoint me as a volunteer coach. The South
Orange Department of Recreation & Cultural Affairs reserves the right to appoint or not appoint volunteer
coaches at their discretion. I have read
the above sections and the reverse of this form and by signing this consent, I accept all conditions stated herein.
Coach/Volunteer Information: PLEASE PRINT NEATLY
_________________________ _______________________ ______________________
Last Name First Name Middle Name (required)
_________________________________________________
Social Security #
_______/________/_____
Date of Birth
___________________________________________ _________________________ ______ _________
Address
Town
State
Zip
_
________________________________________________________________________________________
Previous address if less than 5 years
_____________________________ _______________________________ __________________________
Home Phone
Business Phone
Cell Phone
_
________________________________________________________________________________________
E-Mail Address (PLEASE PRINT NEATLY)
Have you ever been convicted of a crime or disorderly persons offense as listed in N.J. PL15A:3A-3, which
would disqualify you as a volunteer coach? ____________ (yes or no)
If yes, list crime/offense and date of conviction:
_______________________________________________________________ ________________________
Signature Date
Thank you for your application. Your cooperation will help us provide a safe and healthy recreation
experience
for the youth of our community.
NOTE:
1. Information collected by the South Orange Department of Recreation & Cultural Affairs in order to
conduct background searches (such as driver’s license or date of birth) will be kept strictly
confidential.
2. In compliance with the Fair Credit Reporting Act, if an applicant has a criminal record with regard to
crimes detailed in the List of Disqualifiers, the applicant will be notified directly by the criminal
background search agency or company and information will be provided for the applicant to receive
a copy of his or her criminal record.
3. Disqualifications pursuant to this policy are automatic; however a disqualified individual may appeal
his or her disqualification through an appeals process.
Pursuant to the State of New Jersey Public Law 1999
Chapter 432
Conditions under which person is disqualified from service as a volunteer, C.15A:3A-3
3. A person may be disqualified from serving as an employee or volunteer of a nonprofit youth serving
organization if that person’s criminal history record background check reveals a record of conviction of
any of the following crimes and offenses:
a. In New Jersey, any crime or disorderly offense:
(1) involving danger to the person, meaning those crimes and disorderly persons offenses set forth in
N.J.S.2C:11-1 et seq., Homicide – All Offenses, N.J.S.2C:12-1 et seq., Assault; Endangering; threats
– All Offenses, N.J.S.2C:13-1 et seq., Kidnapping – All Offenses, N.J.S.2C:14-1 et seq., Sexual
Offenses – All Offenses, N.J.S.2C:15-1 et seq., Robbery – All Offenses.
(2) against the family, children or incompetents, meaning those crimes and disorderly persons
offenses
set forth in N.J.S.2C:24-1 et seq., Offenses Against the Family, Children and Incompetents – All
Offenses.
(3) Involving theft as set forth in chapter 20 of Title 2C of New Jersey Statutes; Theft – All Offenses.
(4) Involving any controlled dangerous substance or controlled substance analog as set forth in
chapter 35
of Title 2C of the New Jersey Statutes except paragraph (4) of subsection a. of N.J.S.2C:35-10;
(Exceptions include possession of 50 grams or less of marijuana or five grams or less of hashish).
b. In any other state or jurisdiction, conduct which, if committed in New Jersey, would constitute any of
the crimes or disorderly persons offenses described in subsection a. of this section.
Completed form must be returned to the South Orange Dept. of Recreation, Attention: Kate
Schmidt