Middle School Coach

Middle School Coach Registration Form

This form is for all coaches planning to participate in our program. ALL COACHES participating on the bench (Max 3 per team) ARE REQUIRED to complete and submit individual registration forms.

By filling out this form, you provide us with information to understand your coaching experience and background better.

As a coach in our program, you will have the chance to positively impact student athletes’ lives, help them develop their skills and foster a supportive team environment.

Together, we can create an enriching and successful coaching experience. Thank you for joining our SMARTBALL network at YES Inc.

If you have any questions or encounter any issues while completing the form, please do not hesitate to contact us at: info@yesinc.org.

Welcome to YES Inc. and the SMARTBALL Initiative.

"*" indicates required fields

General Information

First Name*

Middle Name

Last Name*

USAB License #:

Team*

City*

State*

Background and Certifications

Check All That Apply To You

Have you ever been previously placed on probation, dismissed, expelled, suspended or refused participation in a youth program?

Are you a sports agent, employed by a sports agent or have an association with a sports agent? [Sports agency = an agency involved in the marketing of any individual's athletics reputation or ability.] A nonscholastic coach is not an agent and should NOT check this box.

Are you employed at an NCAA institution?

Are you currently employed as a basketball COACH at an NCAA institution?

Do you have a First Aid certification / valid 3 years?

Do you have an adult CPR/AED certification / valid 2 years?

Do you have a Concussion Protocol certification / valid 2 years?

First Aid Certification Expiration Date

Adult CPR/AED Certification Expiration Date

Concussion Protocol Certification Expiration Date

Contact Information

Email*

Enter Email Confirm Email

Phone Number*

Alt Phone Number

Team Social Media

Team Website (Include Link)*

Team Instagram Handle

Personal Social Media

Instagram Handle

Facebook Handle

Eligibility Statement

As an Adult/Coach registrant, you attest that each student-athlete that appears on your roster is entering 6th, 7th or 8th grade in September 2023 and will not turn 16 years or older before December 31st 2023.

Coach E-Signature (Print full name)*

Coaches Email*

Enter Email Confirm Email

Get in Touch