SNO VALLEY NORTH LITTLE LEAGE UMPIRES

This application does not guarantee selection. You must also complete and submit the ‘Request for WSP Criminal History Information’ form. If you pass the Criminal History Investigation, complete your umpire training and become certified by the Chief Umpire, this application then becomes a valid contract between you and the league.

In order to be valid, all pages of this application must be completed.

Please print legibly.

Personal Information

Name: ____________________________ Date of Birth: ________________ Age: ________

Last First M.I. Month/Day/Year

Home Address: ___________________________ City: _________________ Zip: _________

Mailing Address: __________________________ City: _________________ Zip: _________

Home Phone (incl. area code): _________________ Work Phone (incl. area code): ____________

Pager (incl. area code): ______________________ Cell Phone (incl. area code): _____________

Email ID: ________________________________ Driver’s License # / State: _____________

Employer: ________________________________ Occupation_________________________

Name(s) and age(s) of children participating in our league:_______________________________

__________________________________________________________________________

Umpire History:

Little League: # of years: ______ Most recent year: ______ Where: _________________________

Other Programs: What: _____________ # of years: ______ Where: ________________________

Other Youth Sports: What: __________ # of years: ______ Where: ________________________

Umpire Training:

Sport: _________________ # of years: ______ Most recent Year: ______ Type: ______________

Other youth activities supervised (give details): __________________________________________

Character References:

Character Reference 1: ________________________ Phone (incl area code): -_________________

Character Reference 2: ________________________ Phone (incl area code): -_________________

Umpire Commitment

1. I will attend all League-mandated Umpire meetings.

2. I will participate in various league functions: Grand Slam Jam, Fund Raising, Field Prep Days, promotions, clinics, training sessions, etc.

I will be responsible for the proper safeguarding and use of all league equipment, facilities, and uniforms. In my role as Umpire I will be personally responsible for the return (or replacement) of all equipment and league property issued to me.

I will learn and abide by the rules of Little League BaseballÒ and the applicable local league rules. I am willing to accept – as final – the decisions of the local league Board of Directors.

5. I will attend league or District 9 clinics on coaching, rules, first aid, and safety.

6. I will endeavor to learn more about the game (baseball or softball) and how to teach young people the correct manner in which to play the game.

7. I will work with league personnel to make players and parents aware of the concepts of teamwork, sportsmanship, fair play and respect for one another; including the other team, umpires and league officials.

8. I understand that the use of offensive language, consumption of alcoholic beverages, and smoking are strictly prohibited while representing or acting in any capacity which may be associated with the league.

In making the application, I hereby swear under penalty of perjury the following: I am not a user orf distributor of illegal drugs. I do not drink alcoholic beverages to excess and I will not partake of any alcoholic beverage before, during or after any league function. At this time I am not nor, during the past four years have I been, under psychiatric care, the nature of which would affect my relationship with the league or any of its participants. I am not now, nor have I ever been, accused of, been under suspicion of, or been convicted of any offenses of a sexual nature. I agree to any background or character checking the league may deem appropriate.

______________________________________ ____________________________________

Signature of applicant date

For League Use Only
Criminal History Check	Passed: _____ Failed: ______		Date:
Training & Certification	Approved: ______ Not Approved: _____		Date:
Approved to Umpire:	Baseball: _____ Softball: _____	Division(s):		Team:
Umpire Provided by the following teams: