St. Lukes UMC Upward Basketball logo

St. Luke's Upward Coach/Referee Registration Forms

Please fill out all fields


Please select one:
  I plan to COACH   I plan to REFEREE   I plan to COACH and REFEREE
I understand that I am volunteering to coach a one hour practice each week and attend on game day for one hour to coach. Note: K and 5-6 grade games scheduled Friday evenings.

Section 1

First Name:   Middle Initial:    Last Name:

Phone (H): () - Phone (W): () -
Home Address: City:
State: Zip:
Date of birth: (mth, day, year)  /   /  Gender:
Email address:

Do you know of someone who might be interested in coaching Upward Basketball this year?

Name:  Phone: (- This person will be my Co-Coach 

Only two coaches per team please


Section 2

  Male Female   1st Choice 2nd Choice   1st Choice 2nd Choice
1. What is your shirt size? 2. What is your preferred practice day? 3. What is your preferred practice time?

**7:00 practice available Monday + Tuesday ONLY; Kindergarten coaches should be available to coach at 4:00.

4. Please list your children who will be playing in this year's Upward League and if you plan to coach their team. If no children indicate grade level and gender you would like to coach.

Child's name Grade Gender I plan to coach my child's team

Referee Applicants Only

5. If you are not coaching please select which league you prefer to officiate. Note that K+ 5/6 grade leagues play on Friday.

To select more than one grade, hold down the CTRL key while clicking.

6. We need coaches and referees to help with Player Evaluations from 5:00-7:30 PM. Please indicate on which Evaluation Night you can help.

To select more than one date, hold down the CTRL key while clicking.

7. Please select which Coach and Referee Training Conference you will attend: (REQUIRED!)

8. Have you ever coached Upward Basketball before?

9. If you are going to officiate have you ever officiated Upward Basketball before?


Section 3

10. Are you a member of a local church?    If yes, which one?

11. Have you made a personal commitment to Jesus Christ?

12. Please share a little about your relationship with Jesus.