TAMALPAIS UNION HIGH SCHOOL DISTRICT
Larkspur, California
APPLICATION FOR COACHING CERTIFICATION
Name_____________________________________________________ Date of Birth______________________
Address___________________________________________________ Phone Number_____________________
City, Zip____________________________________________________________________________________
Coaching Assignment_________________________________________School_______________________
COMPETENCY CONDITIONS (California Code of Regulations, Title 5: Division 1, Ch. 6, Subchapter 2,
Article 5, Sections 5590-5596: Duties of Temporary Athletic Team Coaches)
1. Care and prevention of athletic injuries, basic sports injury first aid, and emergency procedures as
evidenced by one or more of the following:
_____ a. Completion of a college-level course in the care and prevention of athletic injuries and possession of a
valid cardiopulmonary resuscitation (CPR) card; OR
_____ b. A valid sports injury certificate or first aid card, and a valid cardiopulmonary resuscitation (CPR) card;
OR
_____ c. A valid Emergency Medical Technician (EMT) I or II card; OR
_____ d. A valid trainer’s certification issued by the National or California Athletic Trainers’ Association
(NATA/CATA); OR
_____ e. The person has had practical experience under the supervision of an athletic coach or trainer, or has
assisted in team athletic training and conditioning, and has both valid CPR and first aid cards.
Verified by
_________________________________________________________Date_______________________
Name and Title
2. Coaching theory and techniques in the sport or game being coached, as evidenced by one or more of the
following:
_____ a. Completion of a college course in coaching theory and techniques; OR
_____ b. In-service programs arranged by a school district or a county Office of Education; OR
_____ c. Prior service as a student coach or assistant athletic coach in the sport or game being coached; OR
_____ d. Prior coaching in the community youth athletic programs in the sport to be coached; OR
_____ e. Prior participation in organized competitive athletics at high school level or above in the sport to be
coached.
Verified by
_________________________________________________________Date_______________________
Name and Title
3. Knowledge of the rules and regulations pertaining to the sport or game being coached, the rules and
regulations pertaining to the California Interscholastic Federation, North Coast Section, Marin County
Athletic League and Tamalpais Union High School District Athletic Policies.
Verified by
_________________________________________________________Date_______________________
Name and Title
4. Adolescent psychology as it relates to sports participation as evidenced by one or more of the following:
_____ a. Completion of a college-level course in adolescent or sports psychology; OR
_____ b. Completion of a seminar or workshop on human growth and development of youth; OR
_____ c. Prior active involvement with youth in a school or community sports program.
Verified by _________________________________________________________Date_______________________
Name and Title
I certify that I have met the requirements as noted above for the necessary competencies to serve as a non-certificated
coach.
Signed: ___________________________________________________________________Date____________________
Coach
GENERAL CONDITIONS
_____ a. A thorough annual search of the District’s certificated employees has failed to fulfill the District’s coaching needs.
_____ b. The non-certificated person selected as HEAD COACH is at least 21 years of age.
_____ c. The District has first determined that the non-certificated person has not been convicted of any offense referred to
in Education Code Sections 44010, 44011 and 44424 or any offense involving moral turpitude or evidencing
unfitness to associate with children. To be verified by the fingerprinting process.
_____ d. The District has on file a written statement from a licensed physician that the non-certificated person is free from
tuberculosis and any other contagious disease that would prohibit certificated teachers from teaching. The
statement shall be renewed every four years.
_____ e. That after his or her initial school year as a coach, the non-certificated person attends annually at least one available
seminar, workshop or other staff development program related to sports medicine.
Evidenced by _________________________________________________________Date_______________________
Athletic Director
Approved by _________________________________________________________Date_______________________
Principal or Designee
Note: The District may waive compliance with any one or more of the requirements described in Competency Conditions,
provided that the non-certificated person is enrolled in a training program related to the requirement not met and provided the
person serves under the immediate supervision of a fully-qualiffied certificated or non-certificated coach at each practice and
game.