Little League Baseball Pitcher Eligibility Tracking FormDivision - PDF document

1 ____________________ Little League -- Ba
____________________ Little League -- Baseball Pitcher Eligibility Tracking FormDivision ___________________ Team ____________________ _ Eligible to pitchagain on (date) DatePitchesPitcher'sUnif.LeagueTm. Manager's Opp. Manager's Scorekeeper/Umpof GameThrownNameNo.AgeSignature *Signature *Signature *Pitching eligibility varies by the league age of the pitcher, which is the pitcher's age as of May 1 of the current year. The itching eligibility regulation is Regulation VI (see current rule book for details). An electronic version of this form is available for free download at www.LitleLeague.org. *Note: These signatures may be optional as determined by the local league. ____________________ Little League -- Baseball Pitcher Eligibility Tracking FormDivision ___________________ Team ____________________ _ Eligible to pitchagain on (date) DatePitchesPitcher'sUnif.LeagueTm. Manager's Opp. Manager's Scorekeeper/Umpof GameThrownNameNo.AgeSignature *Signature *Signature *Pitching eligibility varies by the league age of the pitcher, which is the pitcher's age as of May 1 of the current year. The itching eligibility regulation is Regulation VI (see current rule book for details). An electronic version of this form is available for free download at www.LitleLeague.org. *Note: These signatures may be optional as determined by the local league. (Typically 46-50' Pitching Distance) •Focus on athleticism, physical fitness, and fun •Focus on learning baseball rules, general techniques, and teamwork •Do not exceed 80 combined innings pitched in any 12 month period •Take at least 4 months off from throwing every year, with at least 2-3 of those months being continuous •Make sure to properly warm up before pitching •Set and follow pitch-count limits and required rest periods •Avoid throwing pitches other than fastballs and

2 change-ups •Avoid playing for multiple t
change-ups •Avoid playing for multiple teams at the same time •Avoid playing catcher while not pitching •Avoid pitching in multiple games on the same day •Play other sports during the course of the year •Monitor for other signs of fatigue •Pitchers once removed from the mound may not return as pitchers AGE DAILY MAX (PITCHES IN GAME) REQUIRED REST (PITCHES) 0 Days1 Days2 Days3 Days4 Days 9-10 75 1-20 21-3536-5051-65 66+ 11-12 85 1-20 21-3536-5051-65 66+ AGES 9 TO 12 Pitch Smart | MLB.com (Typically 60' Pitching Distance) •Players can begin using breaking pitches after developing consistent fastball and changeup •Do not exceed 100 combined innings pitched in any 12 month period •Take at least 4 months off from throwing every year, with at least 2-3 of those months being continuous •Make sure to properly warm up before pitching •Set and follow pitch-count limits and required rest periods •Avoid playing for multiple teams at the same time •Avoid playing catcher while not pitching •Avoid pitching in multiple games on the same day •Play other sports during the course of the year •Monitor for other signs of fatigue •A pitcher remaining in the game, but moving to a different position, can return as a pitcher anytime in the remainder of the game, but only once per game AGE DAILY MAX (PITCHES IN GAME) REQUIRED REST (PITCHES) 0 Days1 Days2 Days3 Days4 Days 13-14 95 1-20 21-3536-5051-65 66+ AGES 13 TO 14 Pitch Smart | MLB.com MEDICAL RELEASE NOTE : To be carried by any Regular Season or Tournament Team Manager together with team roster or Interna�onal Tournament a�davit. Player: _____________________________________ Date of Birth: ____________ Gender (M/F):_________________ Parent (s)/Guardian Name:_____________________________________ Rela�onship:____________________________ Parent (s)/Guardian Na

3 me:_____________________________________
me:_____________________________________ Rela�onship:____________________________ Player’s Address:____________________________________ City:_______________ State/Country:________ Zip:______ Home Phone:_____________________ Work Phone:______________________ Mobile Phone:_____________________ PARENT OR LEGAL GUARDIAN AUTHORIZATION: Email: ____________________________ Emergency Personnel. (i.e. EMT, First Responder, E.R. Physician) Family Physician: ____________________________________________ Phone: _________________________________ Address: __________________________________________ City:________________ State/Country:_________________ Hospital Preference: __________________________________________________________________________________ Parent Insurance Co:_________________________ Policy No.:__________________Group ID#:_____________________ League Insurance Co:_________________________ Policy No.:__________________League/Group ID#:______________ If parent(s)/legal guardian cannot be reached in case of emergency, contact: ___________________________________________________________________________________________________ Rela�onship to Player ___________________________________________________________________________________________________ Rela�onship to Player Medical Diagnosis Medica�on Dosage Frequency of Dosage Date of last Tetanus Toxoid Booster: ______________________________________________________________________ The purpose of the above listed informa�on is to ensure that medical personnel have details of any medical problem which may interfere with or alter treatment. Mr./Mrs./Ms. ________________________________________________________________________________________ Authorized Parent/Guardian Signature Date: FOR LEAGUE USE ONLY:

4 League Name:____________________________
League Name:_______________________________________________ League ID:________________________________ Division:_________________________________Team:______________________________ Date:____________________ Li�le League does not limit par�cipa�on in its ac�vi�es on the basis of disability, race, color, creed, na�onal origin, gender, sexual preference or religious preference. MEDICAL RELEASE NOTE : To be carried by any Regular Season or Tournament Team Manager together with team roster or Interna�onal Tournament a�davit. Player: _____________________________________ Date of Birth: ____________ Gender (M/F):_________________ Parent (s)/Guardian Name:_____________________________________ Rela�onship:____________________________ Parent (s)/Guardian Name:_____________________________________ Rela�onship:____________________________ Player’s Address:____________________________________ City:_______________ State/Country:________ Zip:______ Home Phone:_____________________ Work Phone:______________________ Mobile Phone:_____________________ PARENT OR LEGAL GUARDIAN AUTHORIZATION: Email: ____________________________ Emergency Personnel. (i.e. EMT, First Responder, E.R. Physician) Family Physician: ____________________________________________ Phone: _________________________________ Address: __________________________________________ City:________________ State/Country:_________________ Hospital Preference: __________________________________________________________________________________ Parent Insurance Co:_________________________ Policy No.:__________________Group ID#:_____________________ League Insurance Co:_________________________ Policy No.:__________________League/Group ID#:______________ If parent(s)/lega

5 l guardian cannot be reached in case of
l guardian cannot be reached in case of emergency, contact: ___________________________________________________________________________________________________ Rela�onship to Player ___________________________________________________________________________________________________ Rela�onship to Player Medical Diagnosis Medica�on Dosage Frequency of Dosage Date of last Tetanus Toxoid Booster: ______________________________________________________________________ The purpose of the above listed informa�on is to ensure that medical personnel have details of any medical problem which may interfere with or alter treatment. Mr./Mrs./Ms. ________________________________________________________________________________________ Authorized Parent/Guardian Signature Date: FOR LEAGUE USE ONLY: League Name:_______________________________________________ League ID:________________________________ Division:_________________________________Team:______________________________ Date:____________________ Li�le League does not limit par�cipa�on in its ac�vi�es on the basis of disability, race, color, creed, na�onal origin, gender, sexual preference or religious preference. MEDICAL RELEASE NOTE : To be carried by any Regular Season or Tournament Team Manager together with team roster or Interna�onal Tournament a�davit. Player: _____________________________________ Date of Birth: ____________ Gender (M/F):_________________ Parent (s)/Guardian Name:_____________________________________ Rela�onship:____________________________ Parent (s)/Guardian Name:_____________________________________ Rela�onship:____________________________ Player’s Address:_____________________

6 _______________ City:_______________ Sta
_______________ City:_______________ State/Country:________ Zip:______ Home Phone:_____________________ Work Phone:______________________ Mobile Phone:_____________________ PARENT OR LEGAL GUARDIAN AUTHORIZATION: Email: ____________________________ Emergency Personnel. (i.e. EMT, First Responder, E.R. Physician) Family Physician: ____________________________________________ Phone: _________________________________ Address: __________________________________________ City:________________ State/Country:_________________ Hospital Preference: __________________________________________________________________________________ Parent Insurance Co:_________________________ Policy No.:__________________Group ID#:_____________________ League Insurance Co:_________________________ Policy No.:__________________League/Group ID#:______________ If parent(s)/legal guardian cannot be reached in case of emergency, contact: ___________________________________________________________________________________________________ Rela�onship to Player ___________________________________________________________________________________________________ Rela�onship to Player Medical Diagnosis Medica�on Dosage Frequency of Dosage Date of last Tetanus Toxoid Booster: ______________________________________________________________________ The purpose of the above listed informa�on is to ensure that medical personnel have details of any medical problem which may interfere with or alter treatment. Mr./Mrs./Ms. ________________________________________________________________________________________ Authorized Parent/Guardian Signature Date: FOR LEAGUE USE ONLY: League Name:_______________________________________________ League ID:________________________________ Division:_____________________

7 ____________Team:_______________________
____________Team:______________________________ Date:____________________ Li�le League does not limit par�cipa�on in its ac�vi�es on the basis of disability, race, color, creed, na�onal origin, gender, sexual preference or religious preference. MEDICAL RELEASE NOTE : To be carried by any Regular Season or Tournament Team Manager together with team roster or Interna�onal Tournament a�davit. Player: _____________________________________ Date of Birth: ____________ Gender (M/F):_________________ Parent (s)/Guardian Name:_____________________________________ Rela�onship:____________________________ Parent (s)/Guardian Name:_____________________________________ Rela�onship:____________________________ Player’s Address:____________________________________ City:_______________ State/Country:________ Zip:______ Home Phone:_____________________ Work Phone:______________________ Mobile Phone:_____________________ PARENT OR LEGAL GUARDIAN AUTHORIZATION: Email: ____________________________ Emergency Personnel. (i.e. EMT, First Responder, E.R. Physician) Family Physician: ____________________________________________ Phone: _________________________________ Address: __________________________________________ City:________________ State/Country:_________________ Hospital Preference: __________________________________________________________________________________ Parent Insurance Co:_________________________ Policy No.:__________________Group ID#:_____________________ League Insurance Co:_________________________ Policy No.:__________________League/Group ID#:______________ If parent(s)/legal guardian cannot be reached in case of emergency, contact: _________________________________________________________________________

8 __________________________ Rel
__________________________ Rela�onship to Player ___________________________________________________________________________________________________ Rela�onship to Player Medical Diagnosis Medica�on Dosage Frequency of Dosage Date of last Tetanus Toxoid Booster: ______________________________________________________________________ The purpose of the above listed informa�on is to ensure that medical personnel have details of any medical problem which may interfere with or alter treatment. Mr./Mrs./Ms. ________________________________________________________________________________________ Authorized Parent/Guardian Signature Date: FOR LEAGUE USE ONLY: League Name:_______________________________________________ League ID:________________________________ Division:_________________________________Team:______________________________ Date:____________________ Li�le League does not limit par�cipa�on in its ac�vi�es on the basis of disability, race, color, creed, na�onal origin, gender, sexual preference or religious preference. LOCAL LEAGUE USE ONLY: Background check completed by league o�cer ________________________________ System)s) used for background check (minimum of one must be checked): Sex O�ender Registry Criminal History Records *First Advantage *Please be advised that if you use First Advantage and there is a name match in the few states where only name match searches can be performed you should no�fy volunteers that they will receive a le�er directly from LexisNexis in compliance with the Fair Credit Repor�ng Act containing informa�on regarding all the criminal records associated with the name

9 , which may not necessarily be the leag
, which may not necessarily be the league volunteer. reports that reveal convic�ons of this applica�on. ® Volunteer Applica�on - 2016 Do not use forms from past years. Use extra paper to complete if addi�onal space is required. Please list three references, at least one of which has knowledge of your par�cipa�on as a volunteer in a youth program: IF YOU LIVE IN A STATE THAT REQUIRES A SEPARATE BACKGROUND CHECK BY LAW, PLEASE ATTACH A COPY h�p://www.li�leleague.org/learn/programs/childprotec�on/state-laws-bg-checks.htm AS A CONDITION OF VOLUNTEERING, I give permission for the Li�le League organiza�on to conduct background check(s) on me now and as long as I con�nue to be ac�ve with the organiza�on, which may include a review of sex o�ender 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 posi�on is condi�onal upon the league receiving no inappropriate informa�on on my background. I hereby release and agree to hold harmless from liability the local Li�le League, Li�le League Baseball, Incorporated, the o�cers, employees that, regardless of previous appointments, Li�le League is not obligated to appoint me to a volunteer posi�on. If appointed, I understand that, prior to the expira�on of my term, I am subject to suspension by the President and removal by the Board of Directors for viola�on of Li�le League policies or principles. Applicant Signature Date If Minor/Parent Signature____

10 _______________________________Date ____
_______________________________Date __________ Applicant Name(please print or type) NOTE: The local Li�le League and Li�le League Baseball, Incorporated will not discriminate against any person on the basis of race, creed, color, na�onal origin, marital status, gender, sexual orienta�on or disability. A COPY OF VALID GOVERNMENT ISSUED PHOTO IDENTIFICATION MUST BE ATTACHED TO COMPLETE THIS APPLICATION. Date Address State Zip (mandatory with First Advantage or upon request) Home Phone: _____________ E-mail Address: Date of Birth Occupa�on Employer Address Special professional training, skills, hobbies: Community a�lia�ons (Clubs, Service Organiza�ons, etc.): Previous volunteer experience (including baseball/so�ball and year): Do you have children in the program? YesIf yes, list full name and what level? Do you have a valid driver’s license: Yes Driver’s License#: State Have you ever been convicted of or plead guilty to any crime(s) involving or against Yes If yes, describe each in full: Are there any criminal charges pending against you regarding any crime(s) involving or against a minor? Yes No If yes, describe each in full:______________ Have you ever been refused par�cipa�on in any other youth programs? Yes No If yes, explain: In which of the following would you like to par�cipate? (Check one or more.) UmpireField Maintenance ManagerScorekeeperConcession Stand If you lled out a volunteer application last year and your league uses the background check tools provided by Little League International, please ll out the returning volunteer application. Otherwise, please use the standard volunteer application. You must provide the information to a

11 ll the questions in this section In whic
ll the questions in this section In which of the following would you like to volunteer? (Check one or more)League OcialManagerCoachUmpireField MaintenanceScore KeeperConcession StandOther: __________________________AS A CONDITION OF VOLUNTEERING, I give permission for the Little League organization to conduct background Yes No Have you ever been refused participation in any other youth program?If Yes, explain: _______________________________________________________________ Yes No Little League® “Returning” Volunteer Application - 201Do not use forms from past years. Use extra paper to complete if additional space is required.Please update ONLY the information in this section which has changed since last year.Address: _____________________________________________________________________City: ____________________________________________Home Phone: ______________________________Work Phone: _______________________________ E-Mail Address: ____________________Driver’s License #: _________________________________________________Occupation: __________________________________________________________________ Please list three references, at least one of which has knowledge of your participation as a volunteer in a youth program:Name / Phone:Special professional training, skills, hobbies: LOCAL LEAGUE USE ONLY: Background Check completed by league ocer _______________________________________ *Please be advised that if you use First Advantage 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 recieve a letter directly from First Advantage in compliance with the Fair Credit Reporting Act containing information regarding all the criminal association with the name, which may not necessarily be the league volunteer.Only attach

12 to this application copies of background
to this application copies of background checkreports that reveal convictions of this application. Yes No 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: h�p://www.li�leleague.org/learn/programs/childprotec�on/state-laws-bg-checks.htm LOCAL LEAGUE USE ONLY: Background check completed by league o�cer ________________________________ System)s) used for background check (minimum of one must be checked): Sex O�ender Registry Criminal History Records *First Advantage *Please be advised that if you use First Advantage and there is a name match in the few states where only name match searches can be performed you should no�fy volunteers that they will receive a le�er directly from LexisNexis in compliance with the Fair Credit Repor�ng Act containing informa�on regarding all the criminal records associated with the name, which may not necessarily be the league volunteer. reports that reveal convic�ons of this applica�on. ® Volunteer Applica�on - 2016 Do not use forms from past years. Use extra paper to complete if addi�onal space is required. Please list three references, at least one of which has knowledge of your par�cipa�on as a volunteer in a youth program: IF YOU LIVE IN A STATE THAT REQUIRES A SEPARATE BACKGROUND CHECK BY LAW, PLEASE ATTACH A COPY h�p://www.li�leleague.org/learn/programs/childprotec�on/state-laws-bg-checks.htm AS A CONDITION OF VOLUNTEERING, I give permission for the Li�le League organiza�on to conduct background chec

13 k(s) on me now and as long as I con�
k(s) on me now and as long as I con�nue to be ac�ve with the organiza�on, which may include a review of sex o�ender 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 posi�on is condi�onal upon the league receiving no inappropriate informa�on on my background. I hereby release and agree to hold harmless from liability the local Li�le League, Li�le League Baseball, Incorporated, the o�cers, employees that, regardless of previous appointments, Li�le League is not obligated to appoint me to a volunteer posi�on. If appointed, I understand that, prior to the expira�on of my term, I am subject to suspension by the President and removal by the Board of Directors for viola�on of Li�le League policies or principles. Applicant Signature Date If Minor/Parent Signature___________________________________Date __________ Applicant Name(please print or type) NOTE: The local Li�le League and Li�le League Baseball, Incorporated will not discriminate against any person on the basis of race, creed, color, na�onal origin, marital status, gender, sexual orienta�on or disability. A COPY OF VALID GOVERNMENT ISSUED PHOTO IDENTIFICATION MUST BE ATTACHED TO COMPLETE THIS APPLICATION. Date Address State Zip (mandatory with First Advantage or upon request) Home Phone: _____________ E-mail Address: Date of Birth Occupa�on Employer Address Special professional training, skills, hobbies: Community a�lia�ons (Clubs, Service Organiza�ons,

14 etc.): Previous volunteer experience (in
etc.): Previous volunteer experience (including baseball/so�ball and year): Do you have children in the program? YesIf yes, list full name and what level? Do you have a valid driver’s license: Yes Driver’s License#: State Have you ever been convicted of or plead guilty to any crime(s) involving or against Yes If yes, describe each in full: Are there any criminal charges pending against you regarding any crime(s) involving or against a minor? Yes No If yes, describe each in full:______________ Have you ever been refused par�cipa�on in any other youth programs? Yes No If yes, explain: In which of the following would you like to par�cipate? (Check one or more.) UmpireField Maintenance ManagerScorekeeperConcession Stand If you lled out a volunteer application last year and your league uses the background check tools provided by Little League International, please ll out the returning volunteer application. Otherwise, please use the standard volunteer application. You must provide the information to all the questions in this section In which of the following would you like to volunteer? (Check one or more)League OcialManagerCoachUmpireField MaintenanceScore KeeperConcession StandOther: __________________________AS A CONDITION OF VOLUNTEERING, I give permission for the Little League organization to conduct background Yes No Have you ever been refused participation in any other youth program?If Yes, explain: _______________________________________________________________ Yes No Little League® “Returning” Volunteer Application - 201Do not use forms from past years. Use extra paper to complete if additional space is required.Please update ONLY the information in this section which has changed since last year.Address: __________

15 ________________________________________
___________________________________________________________City: ____________________________________________Home Phone: ______________________________Work Phone: _______________________________ E-Mail Address: ____________________Driver’s License #: _________________________________________________Occupation: __________________________________________________________________ Please list three references, at least one of which has knowledge of your participation as a volunteer in a youth program:Name / Phone:Special professional training, skills, hobbies: LOCAL LEAGUE USE ONLY: Background Check completed by league ocer _______________________________________ *Please be advised that if you use First Advantage 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 recieve a letter directly from First Advantage in compliance with the Fair Credit Reporting Act containing information regarding all the criminal association with the name, which may not necessarily be the league volunteer.Only attach to this application copies of background checkreports that reveal convictions of this application. Yes No 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: h�p://www.li�leleague.org/learn/programs/childprotec�on/state-laws-bg-checks.htm LOCAL LEAGUE USE ONLY: Background check completed by league o�cer ________________________________ System)s) used for background check (minimum of one must be checked): Sex O�ender Registry Criminal History Records *First Advantage *Please be advised that if you use First Advantage and there is a

16 name match in the few states where only
name match in the few states where only name match searches can be performed you should no�fy volunteers that they will receive a le�er directly from LexisNexis in compliance with the Fair Credit Repor�ng Act containing informa�on regarding all the criminal records associated with the name, which may not necessarily be the league volunteer. reports that reveal convic�ons of this applica�on. ® Volunteer Applica�on - 2016 Do not use forms from past years. Use extra paper to complete if addi�onal space is required. Please list three references, at least one of which has knowledge of your par�cipa�on as a volunteer in a youth program: IF YOU LIVE IN A STATE THAT REQUIRES A SEPARATE BACKGROUND CHECK BY LAW, PLEASE ATTACH A COPY h�p://www.li�leleague.org/learn/programs/childprotec�on/state-laws-bg-checks.htm AS A CONDITION OF VOLUNTEERING, I give permission for the Li�le League organiza�on to conduct background check(s) on me now and as long as I con�nue to be ac�ve with the organiza�on, which may include a review of sex o�ender 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 posi�on is condi�onal upon the league receiving no inappropriate informa�on on my background. I hereby release and agree to hold harmless from liability the local Li�le League, Li�le League Baseball, Incorporated, the o�cers, employees that, regardless of previous appointments, Li�le League is not obligated to a

17 ppoint me to a volunteer posi�
ppoint me to a volunteer posi�on. If appointed, I understand that, prior to the expira�on of my term, I am subject to suspension by the President and removal by the Board of Directors for viola�on of Li�le League policies or principles. Applicant Signature Date If Minor/Parent Signature___________________________________Date __________ Applicant Name(please print or type) NOTE: The local Li�le League and Li�le League Baseball, Incorporated will not discriminate against any person on the basis of race, creed, color, na�onal origin, marital status, gender, sexual orienta�on or disability. A COPY OF VALID GOVERNMENT ISSUED PHOTO IDENTIFICATION MUST BE ATTACHED TO COMPLETE THIS APPLICATION. Date Address State Zip (mandatory with First Advantage or upon request) Home Phone: _____________ E-mail Address: Date of Birth Occupa�on Employer Address Special professional training, skills, hobbies: Community a�lia�ons (Clubs, Service Organiza�ons, etc.): Previous volunteer experience (including baseball/so�ball and year): Do you have children in the program? YesIf yes, list full name and what level? Do you have a valid driver’s license: Yes Driver’s License#: State Have you ever been convicted of or plead guilty to any crime(s) involving or against Yes If yes, describe each in full: Are there any criminal charges pending against you regarding any crime(s) involving or against a minor? Yes No If yes, describe each in full:______________ Have you ever been refused par�cipa�on in any other youth programs? Yes No If yes, explain: In which of the following would you like to par�cipate? (Check one or more.) UmpireField Mainten

18 ance ManagerScorekeeperConcession Stand
ance ManagerScorekeeperConcession Stand If you lled out a volunteer application last year and your league uses the background check tools provided by Little League International, please ll out the returning volunteer application. Otherwise, please use the standard volunteer application. You must provide the information to all the questions in this section In which of the following would you like to volunteer? (Check one or more)League OcialManagerCoachUmpireField MaintenanceScore KeeperConcession StandOther: __________________________AS A CONDITION OF VOLUNTEERING, I give permission for the Little League organization to conduct background Yes No Have you ever been refused participation in any other youth program?If Yes, explain: _______________________________________________________________ Yes No Little League® “Returning” Volunteer Application - 201Do not use forms from past years. Use extra paper to complete if additional space is required.Please update ONLY the information in this section which has changed since last year.Address: _____________________________________________________________________City: ____________________________________________Home Phone: ______________________________Work Phone: _______________________________ E-Mail Address: ____________________Driver’s License #: _________________________________________________Occupation: __________________________________________________________________ Please list three references, at least one of which has knowledge of your participation as a volunteer in a youth program:Name / Phone:Special professional training, skills, hobbies: LOCAL LEAGUE USE ONLY: Background Check completed by league ocer _______________________________________ *Please be advised that if you use First Advantage and there is a name match in the f

19 ew states where only name match searches
ew states where only name match searches can be performed you should notify volunteers that they will recieve a letter directly from First Advantage in compliance with the Fair Credit Reporting Act containing information regarding all the criminal association with the name, which may not necessarily be the league volunteer.Only attach to this application copies of background checkreports that reveal convictions of this application. Yes No 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: h�p://www.li�leleague.org/learn/programs/childprotec�on/state-laws-bg-checks.htm LOCAL LEAGUE USE ONLY: Background check completed by league o�cer ________________________________ System)s) used for background check (minimum of one must be checked): Sex O�ender Registry Criminal History Records *First Advantage *Please be advised that if you use First Advantage and there is a name match in the few states where only name match searches can be performed you should no�fy volunteers that they will receive a le�er directly from LexisNexis in compliance with the Fair Credit Repor�ng Act containing informa�on regarding all the criminal records associated with the name, which may not necessarily be the league volunteer. reports that reveal convic�ons of this applica�on. ® Volunteer Applica�on - 2016 Do not use forms from past years. Use extra paper to complete if addi�onal space is required. Please list three references, at least one of which has knowledge of your par�cipa�on as a volunteer in a youth program: IF YOU

20 LIVE IN A STATE THAT REQUIRES A SEPARAT
LIVE IN A STATE THAT REQUIRES A SEPARATE BACKGROUND CHECK BY LAW, PLEASE ATTACH A COPY h�p://www.li�leleague.org/learn/programs/childprotec�on/state-laws-bg-checks.htm AS A CONDITION OF VOLUNTEERING, I give permission for the Li�le League organiza�on to conduct background check(s) on me now and as long as I con�nue to be ac�ve with the organiza�on, which may include a review of sex o�ender 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 posi�on is condi�onal upon the league receiving no inappropriate informa�on on my background. I hereby release and agree to hold harmless from liability the local Li�le League, Li�le League Baseball, Incorporated, the o�cers, employees that, regardless of previous appointments, Li�le League is not obligated to appoint me to a volunteer posi�on. If appointed, I understand that, prior to the expira�on of my term, I am subject to suspension by the President and removal by the Board of Directors for viola�on of Li�le League policies or principles. Applicant Signature Date If Minor/Parent Signature___________________________________Date __________ Applicant Name(please print or type) NOTE: The local Li�le League and Li�le League Baseball, Incorporated will not discriminate against any person on the basis of race, creed, color, na�onal origin, marital status, gender, sexual orienta�on or disability. A COPY OF VALID GOVERNMENT ISSUED PHOTO IDENTIFICATION MUST BE ATTACHED TO

21 COMPLETE THIS APPLICATION. Date Address
COMPLETE THIS APPLICATION. Date Address State Zip (mandatory with First Advantage or upon request) Home Phone: _____________ E-mail Address: Date of Birth Occupa�on Employer Address Special professional training, skills, hobbies: Community a�lia�ons (Clubs, Service Organiza�ons, etc.): Previous volunteer experience (including baseball/so�ball and year): Do you have children in the program? YesIf yes, list full name and what level? Do you have a valid driver’s license: Yes Driver’s License#: State Have you ever been convicted of or plead guilty to any crime(s) involving or against Yes If yes, describe each in full: Are there any criminal charges pending against you regarding any crime(s) involving or against a minor? Yes No If yes, describe each in full:______________ Have you ever been refused par�cipa�on in any other youth programs? Yes No If yes, explain: In which of the following would you like to par�cipate? (Check one or more.) UmpireField Maintenance ManagerScorekeeperConcession Stand If you lled out a volunteer application last year and your league uses the background check tools provided by Little League International, please ll out the returning volunteer application. Otherwise, please use the standard volunteer application. You must provide the information to all the questions in this section In which of the following would you like to volunteer? (Check one or more)League OcialManagerCoachUmpireField MaintenanceScore KeeperConcession StandOther: __________________________AS A CONDITION OF VOLUNTEERING, I give permission for the Little League organization to conduct background Yes No Have you ever been refused participation in any other youth program?If Yes, explain: __

22 ________________________________________
_____________________________________________________________ Yes No Little League® “Returning” Volunteer Application - 201Do not use forms from past years. Use extra paper to complete if additional space is required.Please update ONLY the information in this section which has changed since last year.Address: _____________________________________________________________________City: ____________________________________________Home Phone: ______________________________Work Phone: _______________________________ E-Mail Address: ____________________Driver’s License #: _________________________________________________Occupation: __________________________________________________________________ Please list three references, at least one of which has knowledge of your participation as a volunteer in a youth program:Name / Phone:Special professional training, skills, hobbies: LOCAL LEAGUE USE ONLY: Background Check completed by league ocer _______________________________________ *Please be advised that if you use First Advantage 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 recieve a letter directly from First Advantage in compliance with the Fair Credit Reporting Act containing information regarding all the criminal association with the name, which may not necessarily be the league volunteer.Only attach to this application copies of background checkreports that reveal convictions of this application. Yes No 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: h�p://www.li�leleague.org/learn/programs/childprotec�on/state-laws-bg-checks.htm n n n n n n n