Please complete all required fields. Any fields left blank may delay the processing of this application. Information is kept confidential by the High 5 Sports Ministry Staff.
NOTE: By submitting this registration form to Coach/Team Parent with Bethlehem High 5 Sports, you understand and agree that Bethlehem Church and High 5 Sports, including staff and coaching staffs, are not liable for any injuries incurred during or as a result of your participation in a High 5 Sport, or for any injuries while attending practices, games or events relating to the sport.
Click HERE for
information about becoming a Coach or Team Parent.
Coach or Team Parent Application
Your
Full Name
Today's Date
Name of
Sport
Position Applying For
Your Full Name
Address
City
State
Zip
Email Address
Cell Phone
Home Phone
Work Phone
Best Method of Contact
Social Sec.
#
-Last 4 Digits
Driver's
License #
State:
Date of
Birth
Age
Gender
Male
Female
Name of
Employer
Are you married?
Yes
No
Spouse's
Name
Would your spouse be willing to serve on a coaching staff?
Yes
No
If yes, please have your spouse complete a separate Coach/Team Parent Application Form.
Do you have
children?
Yes
No
List Names &
Ages
How long
have you attended Bethlehem?
Are you involved in a Community Group?
Yes
No
List any
experience you have as a Coach or Team Parent at Bethlehem
List any
other previous experience you as a Coach or Team Parent
List 3
personal references that are over 18 yrs. old and not
related to you. (name, number, relationship)
Your child will be placed on your team. Please list your first and second choice of practice nights for the team you will be a part of. Every attempt will be made to fulfill your first request, but it might be necessary to place you on your second choice night depending on the number of teams and space available.
1st choice -
2nd choice -
Choose your
shirt size (choose carefully - no extra shirts will be
ordered)
Adult Small
Adult Medium
Adult Large
Adult X-Large
In order to maintain a safe environment for our players, parents and coaching staff, we perform random background checks on applicants for head coach, assistant coach and team parent. With the information you have provided on this form and your signature below, you are authorizing High 5 Sports and Bethlehem Church to perform a background check. Failure to sign this form will result in a delay of assigning coaches and/or the decision to allow you to serve on a coaching staff.
your name
Video & Still-Shot Photography will be recorded throughout the season. By submitting this application, you give permission for Bethlehem Church to use video shots or photographs of you in future publicity and end-of-season wrap-up video.
