Volunteer Information First Name * Last Name * Birthdate * Please choose a volunteer option below. * ---Soccer program.Art program.Both programs. Email * Phone * Address * City * State * ---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict Of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming Zip * Medical Information Insurance * Known Allergies (Please type "NA" if there are not any allergies.) * Medical Condition(s) that I should know about if something happens and you need assistance. (Example: you are on blood thinners) * Emergency Contact Information Please list someone other than yourself that we can contact in case of an emergency. First Name * Last Name * Phone * Background & Experience What experience do you have with those who have cognitive and or physical challenges? Please describe below, otherwise type "NA". Do you have any art experience? If so, please describe below, otherwise type "NA". Do you have any soccer experience? If so, please describe below, otherwise type "NA". Are you an ABA Therapist that will be working with a specific individual? YesNo Are you an Interpreter that will be working with a specific individual? YesNo Waivers & Agreements Click here to read the code of conduct Click here to read the concussion waiver » Click here to read the media waiver » Click here to read the release claims statement » Please check one of the boxes below. Yes, I agree to allow PASS to use my image in photos/videos for promotional use.No, I do not want PASS to use my image in photos/videos for promotional use. I have read and agree to the concussion information. I agree to release all claims against PASS. I have read and agree to the PASS Code of Conduct. PLEASE NOTE: Once your registration has been received you will receive a link for completing your background check through Sterling Volunteers. All who are 18 years old or older must complete and pass a background check to volunteer with PASS. Please prove you are human by selecting the Car. Blessings and thank you for registering to be a coach/instructor or volunteer (aka Buddy), this season! If you have any questions please contact Nikki at email@example.com CODE OF CONDUCT Thank you for registering with PASS. By registering to be a volunteer you are in agreement to the following PASS rules and regulations as set forth by the PASS officers and Board of Directors. PASS serves the Greater Spokane and Inland Empire region with the highest levels of integrity and professionalism. It is PASS’s responsibility that the "Code of Conduct" is made clear to those who participate in our programs as players/participants, parents, coaches/instructors, and volunteers. At the time of registration, all participants, coaches/instructors and volunteers (aka Buddies) must agree to the PASS Code of Conduct. PASS Code of Conduct: Participation in playing sports, coaching for a team, instructing art camp or volunteering with a participant sponsored by PASS is a privilege. To ensure a positive experience for all involved, this Code of Conduct shall be enforced. Violation in anyway of this privilege may result in suspensions. Coaches and Volunteers (aka Buddy) Role and Responsibility: Arrive on time (or early) and prepared for the session. Be respectful of all participants, parents, and coaches/volunteers. Teach skills to challenge and increase the ability of individual players. Take personal responsibility to improve your coaching/volunteering skills and ability. Exhibit good sportsmanship and character. Speak kind words, be firm when needed, and when in doubt seek help from the on-site PASS Coordinator. Always notify the PASS Coordinator in advance if you will be unable to show up for a session! Never leave the area with a participant. Do not give participants anything to eat! Many participants have medical conditions or severe allergies. Always cheer your participant on! PASS Player Role and Responsibility: Respect your teammates/other participants, coach, and volunteers Follow the Golden Rule: Treat others the way you would like to be treated. Have FUN! Parents Role and Responsibility: Allow your child to participate with their volunteer and group coach/instructor. This is a time for us to give back to you and let you sit back, talk to other parents, while enjoying watching your participant have fun! Please have your participant ready for indoor or outdoor activities, depending on the season and program. Please notify the PASS Coordinator if you will be unable to attend a session. Please stay in the area in case of a medical emergency and to assist your participant in their bathroom needs. CONCUSSION INFORMATION & WAIVER A concussion is a brain injury and all brain injuries are serious. They are caused by a bump, blow, or jolt to the head, or by a blow to another part of the body with the force transmitted to the head. They can range from mild to severe and can disrupt the way the brain normally works. Even though most concussions are mild, all concussions are potentially serious and may result in complications including prolonged brain damage and death if not recognized and managed properly. In other words, even a "ding" or a bump on the head can be serious. You can’t see a concussion and most sports concussions occur without loss of consciousness. Signs and symptoms of concussion may show up right after the injury or can take hours or days to fully appear. If your child reports any symptoms of concussion, or if you notice the symptoms or signs of concussion yourself, seek medical attention right away. Symptoms: Headaches "Pressure in head" Nausea or vomiting Neck pain Balance problems or dizziness Blurred, double, or fuzzy vision Sensitivity to light or noise Feeling sluggish or slowed down Feeling foggy or groggy Drowsiness Change in sleep patterns Amnesia "Don’t feel right" Fatigue or low energy Sadness Nervousness or anxiety Irritability More emotional Confusion Concentration or memory problems (forgetting game plays) Repeating the same question/comment What you may observe in someone who is suffering from a concussion: Appears dazed Vacant facial expression Confused about assignment Forgets plays Is unsure of game, score, or opponent Moves clumsily or displays incoordination Answers questions slowly Slurred speech Shows behavior or personality changes Can’t recall events prior to hit Seizures or convulsions Any change in typical behavior or personality Loses consciousness MEDIA RELEASE PASS publishes in print, electronic or video format the likeness or image of you for official publications. I agree to allow photographs related to myself in PASS activities to be used by the organization to help promote its mission. I understand PASS owns rights to any and all photographs of which I may be a part of. Release of all Claims against PASS In consideration of permission granted by myself to participate in PASS sports and social activities, I, the coach/instructor, volunteer (aka Buddy) hereby release and discharge PASS, its officers, representatives, coaches/instructors, and fellow volunteers (aka Buddies) from all claims, demands, actions, judgments, and executions which I/myself or child or parent or guardian ever had, now has, or may have, or which I/myself or child or parent or guardian's heirs, executors, administrators or assigns may have or claim to have, against PASS its officers, representatives, coaches/instructors/volunteers, their successors or assigns, for all personal injuries, known or unknown to myself/child/ward, and injuries to property, real or personal, caused by, or arising out of, the above described sports activity. I, Myself/Parent/Guardian, have read this release and understand all its terms. I execute it voluntarily and with full knowledge of its significance.