Name of Coach: Qualifications: (Attach resume) Please list qualifications and experiences relating to coaching this activity:

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1 University of California, Irvine Campus Recreation CLUB SPORTS VOLUNTEER COACH AGREEMENT PLEASE PRINT LEGIBLY Name of Sport Club: Year: Name of Coach: Home Address: Daytime Phone #: Cell Phone #: Address: Please check your preferred contact number. Coach Compensation Volunteer Paid (rate) $ per quarter/year/ *Earned Salary is paid from money raised by the club. All income earned must be reported for tax purposes. Qualifications: (Attach resume) Please list qualifications and experiences relating to coaching this activity: References: Please list three (Name, position, phone #): I understand that I am not considered an employee of the University of California and I am not covered under the University s insurance or workers compensation program. I also certify that I carry my own medical and health insurance coverage. It is also recommended that Club Sports coaches carry personal liability insurance coverage. As a volunteer, any expenses that I incur as a Club Sports coach are not eligible for reimbursement. I have read and understand the responsibilities and obligations of serving as a Club Sports Coach listed in the Club Sports Handbook (a copy is attached to this form). I agree to fulfill those duties and serve in the best interests of the Club and the Club Sports program. Signature (please read and complete the waiver agreement on the reverse side) Club President Approval (Signature & ) Club Sports Director Approval (Signature & )

2 VOLUNTEER RECORD (To be completed by the University and maintained in the Department) Department Name: Campus Recreation Volunteer Name: Assignment Beginning : End : Description of services to be rendered on a volunteer basis*: Name of supervisor for activities: Volunteer Schedule: Monday Tuesday Wednesday Thursday Friday Saturday Sunday Location where volunteer assignment will be performed: [x] Campus [ ] Medical Center [ ] Other Building Name and room number: (please give specific information) (To be completed by the volunteer) Name: Address: Home Phone: Work Phone: Cell Phone: Address: In case of emergency, contact: Name: Relationship to volunteer: Cell Phone: The volunteer service described above will be uncompensated. I understand that either the University or I may discontinue the volunteer service at any time without notice. I agree to abide by the rules and policies of the University. Volunteer Signature University Representative Signature & Title *Services should not include contact with human blood, body fluid or tissue, radioactive compounds or hazardous chemicals without prior consultation with Environmental Health and Safety to ensure the volunteer has the appropriate training, vaccinations and health coverage.

3 Participant s Name: Please Print UNIVERSITY OF CALIFORNIA, IRVINE Campus Recreation and Anteater Recreation Center Club Sport Coach / Advisor Waiver Waiver of Liability, Assumption of Risk, and Indemnity Agreement Waiver: In consideration of being permitted to participate in any way in Campus Recreation or Anteater Recreation Center Programs. Including but not limited to coaching, instructing, or advising Club Sport teams or programs, participating in Club practices, Activity Classes, Special Events, or Drop-in Activities, hereinafter called The Activity, I, for myself, my heirs, personal representatives or assigns, do hereby release, waive, discharge, and covenant not to sue The Regents of the University of California, its officers, employees, and agents from liability from any and all claims including the negligence of The Regents of the University of California, its officers, employees and agents, resulting in personal injury, accidents or illnesses (including death), and property loss arising from, but not limited to, participation in The Activity. Signature of Parent/Guardian of Minor Signature of Participant Assumption of Risks: Participation in The Activity carries with it certain inherent risks that cannot be eliminated regardless of the care taken to avoid injuries. The specific risks vary from one activity to another, but the risks range from 1) minor injuries such as scratches, bruises, and sprains to 2) major injuries such as eye injury or loss of sight, joint or back injuries, heart attacks, and concussions to 3) catastrophic injuries including paralysis and death. I have read the previous paragraphs and I know, understand, and appreciate these and other risks that are inherent in The Activity. I hereby assert that my participation is voluntary and that I knowingly assume all such risks. Indemnification and Hold Harmless: I also agree to INDEMNIFY AND HOLD The Regents of the University of California HARMLESS from any and all claims, actions, suits, procedures, costs, expenses, damages and liabilities, including attorney s fees brought as a result of my involvement in The Activity and to reimburse them for any such expenses incurred. Severability: The undersigned further expressly agrees that the foregoing waiver and assumption of risks agreement is intended to be as broad and inclusive as is permitted by the law of the State of California and that if any portion thereof is held invalid, it is agreed that the balance shall, notwithstanding, continue in full legal force and effect. Acknowledgment of Understanding: I have read this waiver of liability, assumption of risk, and indemnity agreement, fully understand its terms, and understand that I am giving up substantial rights, including my right to sue. I acknowledge that I am signing the agreement freely and voluntarily, and intend by my signature to be a complete and unconditional release of all liability to the greatest extent allowed by law. Signature of Parent/Guardian of Minor Signature of Participant Participants Age (if minor) Volwaiver 5/01

4 RESPONSIBILITIES OF UCI CLUB SPORTS COACHES 1. Coaches/instructors are not considered University employees and are not covered by University medical, health, or liability insurance plans. 2. The selection of a coach/instructor must be approved by a majority of the club's members and is subject to the approval of the Club Sports Director. (A club may not have more than three coaches) 3. All coaches/instructors must complete, sign and submit the coach waiver and agreement form prior to assuming duties. 4. Coaches must demonstrate a level of expertise in their sport. A one-page resume must be on file in the Club Sports office. 5. The coach/instructor must abide by all Campus Recreation, Club Sports, and University rules and regulations. 6. Participation in activities that are not directly related to coaching/instructing responsibilities, or the unauthorized use of equipment, shall result in the immediate removal from the Club Sports program. 7. If in the opinion of the Club Sports Director, the club is misled by the coach, or if the coach is not working in the best interest of the club, s/he will be relieved of all Club Sports functions and responsibilities. 8. Coaches should always keep the club's best interest in mind when dealing with anyone regarding club matters. 9. Coaches should exercise reasonable care and caution in the execution of all coaching/teaching duties in order to reduce the risk of injury. 10. Coaching/teaching is an obligation to instruct, condition, and motivate participants. 11. Coaches should restrict their contribution to those involving knowledge, expertise, and skill in a particular activity. They should refrain from involvement in other areas of budget and club management. 12. Non-student coaches are not eligible for club membership and are prohibited from playing in competitions. 13. First Aid and CPR certifications are strongly recommended of all Club Sports coaches. If you are currently certified, please submit a copy of your certificate/cards. If you are not certified, we recommend becoming certified during your first quarter of coaching. CPR and First Aid classes are offered to Club Sports coaches at a discounted rate at the Anteater Recreation Center. Please contact the Club Sports Director or Campus Recreation Services desk for additional information. 14. Coaches are responsible for their own transportation to and from practices and/or competitions and must purchase their own campus parking permits. 15. Coaches may only be paid through members dues and generated income by the club. Any coach paid for his/her services from monies raised must report all income generated for tax purposes. 16. Coaches must provide certificate of completion of CDC Heads Up Online Concussion Training Course (http://www.cdc.gov/concussion/headsup/training/headsupconcussion.html) & certificate

5 of completion of an understanding of UC harassment policies (http://www.newmedialearning.com/psh/ucirvine/) 17. Responsibilities and duties of coaches include: A. Conducting themselves in an ethical and professional manner. B. Developing and employing safety procedures. C. Promoting and ensuring good sportsmanship on and off the field, court, or in any facility. D. Developing and improving skills and strategies needed to participate. E. Coordinating practices. F. Attending games and practices whenever possible. Initial Here I have read and understand all of the responsibilities of a Club Sports coach/instructor/advisor and agree to adhere to the policies of the Club Sports program. Initial Here I have read and understand all of the responsibilities of a Club Sports coach/instructor/advisor and agree to adhere to the policies of the Club Sports program.

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