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Full Name
Address
Home Phone
Cell Phone
Email
Date of Birth
Occupation and Employer
Employer Contact Information
Preferred Managing Assignment
U7 - INITIATION
U9 - NOVICE
U11 - ATOM
U13 - PEEWEE
U15 - BANTAM
U18 - MIDGET
Managing Experience (year, association, age group)
List any volunteering or managing experience in other sports
A criminal record check is required each coaching year. Criminal record check submitted?
YES
NO
I hereby consent to disclosure of the above information. I hereby acknowledge the authority of the CHA, Hockey Alberta, Fort Macleod Minor Hockey Association and agree to carry out and abide by their constitution, bylaws, rules and regulations. By way of this application, I give permission to Fort Macleod Minor Hockey Association to pursue a criminal record search on myself if necessary.
I agree to the above
I do not agree
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