Umpire Application 2017 Umpire Application UMPIRE INFORMATIONUmpire Name*Full Legal Name Required First Last Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Umpire Date of Birth* MM DD YYYY Social Security Number*123-45-6789Primary Phone*Mobile Numbers are preferred - Area Code is RequiredPrimary Email* Shirt Size*Adult - SmallAdult - MediumAdult - LargeAdult - XLAdult - XXLAdult - 3XLDid you participate last year at TC American Legion?* Yes No Umpired in different league List any Special or Professional Training, Skills, and HobbiesCommunity AffiliationsClubs, Service Organizations, etc.Umpire ExperienceBaseball ExperienceSpecial CertificationsCPR, Medical, etc.Do you have a valid Driver's License*A copy of valid photo identification must be included with your application. Yes No, Other Form of ID Driver's License Number*Other ID*School ID, MI ID, College ID, SS, etc. Tell us what form of ID and the Number in the text field provided. You still need to upload a photo of this ID.Upload IDIf you cannot upload a photo of your ID during online registration, you will need to drop it off or send it to our office. Have you ever been convicted or pleaded guilty to any Felony crime(s)?*If YES, an additional box will allow you to list the information below. Yes No If Yes, explain*ReferencesPlease list three references, at least one of which has knowledge of your participation as a volunteer in a youth program.Name - Reference #1* First Last Phone - Reference #1*Email - Reference #1* Name - Reference #2 First Last Phone - Reference #2Email - Reference #2 Name - Reference #3 First Last Phone - Reference #3Email - Reference #3 Notes to LeagueUse this space to tell us anything specific about your registration or special situations involved with your teams, players or coaches that was not covered in the rest of the Application Form.WAIVER OF LIABILITY*The American Legion Baseball depends on people like you and your dedication. If you are selected to become a umpire for one of the finest programs in the Grand Traverse Area and the United States we expect you to attend your assigned games on time and with out absents. Phone calls, scheduled clinics, and communications with our Field Director is a must to make this an outstanding year in baseball. As a condition of umpiring, I give permission for the American Legion Junior Baseball Program to conduct a background check on me, which may include a review of sex offender, registries, child abuse and criminal history records. I understand that, if appointed, my position is conditional upon the league receiving no inappropriate information on my background. I also understand that the League is not obligated to appoint me to a umpire position. If appointed, I understand that, prior to the expiration of my term, I am subject to suspension or termination by the Director or any Board of Directors for the violation of the League polices, or principles. By signing this application I accept the responsibility and dedication needed for this position. Select Yes to sign this application. Yes No Signature*Use your mouse, touchpad, stylus, or finger on your phone to complete your child's registration. NOTE:The American Legion Junior Baseball Program will not discriminate against any person on the basis of race, religion, national origin, marital status, gender, sexual orientation or disability.EmailThis field is for validation purposes and should be left unchanged.