Date of Birth*

Best way to contact you?

I confirm that I have never been convicted of and have no pending criminal charges involving child abuse, neglect, violence or sexual misconduct?*

Ethnicity*

Are you a:

Position Applying For (select one):

Were you a former or current NCAA Division I student-athlete?*

Were you a former or current professional athlete?*

Was it a Historically Black College/University?

Coaching honorarium is $300 per session. Equipment, T-shirt and lunch are provided. Do you accept these terms?

Coaches are expected to come 2 hours prior to program start time to help with load in and support load out. Do you accept these terms?

All snacks and meals provided are 100% whole food, plant-based/vegan. Are you comfortable supporting and reinforcing this standard?*

I'm aware that this program works directly with youth ages 5-17. *

I'm aware of and support Power is Giving's mission to present optimal wellness & prevention programs that aid in the reduction of risk factors for lifestyle driven chronic illnesses disproportionately impact underserved communities. *