Coaching Form

Required annually for all coaches.

Full Legal Name *
Full Legal Name
Cell Phone *
Cell Phone
Address *
Please list any children you have that will be participating on a Cleveland Basketball team this year. (Enter "n/a" if none.)
You are required to have a USA Basketball ASSOCIATES LICENSE, which requires a background screening & completion of training courses.
Acknowledge: I have watched & understand the CDC Concussion Training video *
Training video can be found at:
Have you coached basketball before? *
Have you coached any other sports? *
Have you had any other formal training as a youth coach? *
Examples include: PE Degree, coaching courses, certifications, online classes, licenses, etc.
Would you be interested in attending a coaches training this year put on by the Portland Trail Blazers? *
Reference *
Please list the name of another person who knows you sufficiently well to comment on your past coaching or your potential as a coach
Reference Phone *
Reference Phone
IMPORTANT: Cleveland Basketball aims to provide an enjoyable and safe learning environment for children to build healthy spirits, minds, and bodies. I understand that this responsibility is extended to me in my role as a coach. I also understand the expectations of playing time allocation & philosophy for the tier that I am coaching. *