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Coach / Referee Application

  1. Have you Coached or Refereed before?*
  2. Do you have an Assistant Coach?*

    If YES, please complete the Assistant Coach information section below.

  3. Do you have a child(ren) playing in Jacksonville sports?*
  4. Liability Release:

    My signature confirms that I hereby release and forever discharge the Jacksonville Parks & Recreation Department, the City of Jacksonville, and their employees from any and all manner of claims, causes of action, or liability, which may exist or may exist at any time in the future, arising out of or pertaining to any injury, loss, damage, or harm of any kind which has, will or may result or occur while participating in this program. 

  5. Leave This Blank:

  6. This field is not part of the form submission.