Bench Staff & On-Ice Helpers Form (Delhi Rockets - Home on the Web)
Winter Session 2
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Bench Staff & On-Ice Helpers Form
Please complete form, with all that pertain to your Team. Team Roster must have a Head Coach and a Trainer for an official OMHA Roster. Manager and Assistant Coach are not required to Roster a Team.
Team ...
*
Select One...
DEV - U6 - YOB 2015
DEV - U5 - YOB 2016-2017
DEV - U8 - YOB 2013
DEV - U7 - YOB 2014
U18 - U18M - midget
DEV - U9 - YOB 2012
DEV - U10 - YOB 2011
DEV - U11 - YOB 2010
DEV - U12 - YOB 2009
DEV - U13 - YOB 2008
DEV - U14 - YOB 2007
DEV - U15 - YOB 2006
DEV - U16 - YOB 2005
DEV - U17 - YOB 2004
U5 - U5-ALL
DEV - U18 - YOB 2003
DEV - U21 - YOB 2000-02
U7 - TEAM 1
U7 - TEAM 2
U8 - U8
U9 - GROUP A
U9 - GROUP B
U9 - TEAM 1
U9 - TEAM 2
U9 - TEAM 3
U9 - TEAM 4
U11 - FARROW
U11 - STEPHEN
U11 - POIRIER
U11 - KICHLER
U13 - HOWDEN
U13 - NIGHTINGALE
U13 - VANDEVELDE
U13 - TEAM 4
U15 - GROUP A
U15 - GROUP B
U15 - TEAM 1
U15 - TEAM 2
U15 - TEAM 3
U18 - VANWYNSBERGHE
U18 - HARE
U18 - MABEE
U18 - TEAM 4
OPEN ICE
Bench Staff
Please provide information for all your bench staff. Must have Head Coach & Trainer to submit to OMHA for Roster. 5 staff can be on Roster Total
Head Coach's Name
*
Head Coach Date of birth
*
mm/dd/yyyy
Head Coach's Qualifications
*
Coach 1 - Intro to Coach
Coach 2 - Coach Level
Development 1 - Trained
Development 1 - Certified
High Performance 1 - Certified
SPEAK OUT
RIS - ACTIVITY LEADER
Gender Identity & Expression Course
Rowan's Law Acknowledgment
Check All That Apply
Head Coach's Phone
*
Example: ###-###-####
Head Coach's Email
*
Example:
[email protected]
Date of Last Police Check
on file with DMHA? mm/dd/yyyy
Trainer's Name
*
Trainer Date of birth
*
mm/dd//yyyy
Trainer's Qualifications
*
HTCP LEVEL 1
HTCP LEVEL 2
HTCP LEVEL 3
SPEAK OUT
RIS - ACTIVITY LEADER
Gender Identity & Expression Course
Rowan's Law Acknowledgement
Check All That Apply
Trainer's Phone
*
Example: ###-###-####
Trainer's Email
*
Example:
[email protected]
Date of Last Police Check?
on file with DMHA?
Manager's Name
*
Manager's Qualifications
*
OMHA Manager Training
SPEAK OUT
RIS - ACTIVITY LEADER
Gender Expression & Identity Course
Rowan's Law Acknowledgement
Check All That Apply
Manager's Phone
*
Example: ###-###-####
Manager's Email
*
Example:
[email protected]
Date of Last Police Check?
on file with DMHA?
Assistant Coach/Trainer Name
Assistant Coach/Trainer Qualifications
Assistant Coach/Trainer Phone
Example: ###-###-####
Assistant Coach/Trainer Email
Example:
[email protected]
Date of Last Police Check
Assitant Trainer/Coach Name
Assitant Trainer/Coach Qualifications
Assitant Trainer/Coach Phone
Example: ###-###-####
Assitant Trainer/Coach Email
Example:
[email protected]
Date of Last Police Check
mm/dd/yyyy
On Ice Helpers
Please provide information for all your on ice helpers - Must have On-Ice Helper Form
On Ice Helper #1 : Name
On Ice Helper #1 : Qualifications
Date of last Police Check?
on file with DMHA?
On Ice Helper #1 : Phone
Example: ###-###-####
On Ice Helper #1 : Email
Example:
[email protected]
On Ice Helper #2 : Name
On Ice Helper #2 : Qualifications
Date of Last Police Check
on file with DMHA?
On Ice Helper #2 : Phone
Example: ###-###-####
On Ice Helper #2 : Email
Example:
[email protected]
Date of Last Police Check
on file with DMHA?
I have completed Form to be true and accurate as it pertains to my Team Staff and Support Staff.
DMHA = Delhi Minor Hockey Association - Documents to be kept with DMHA Registrar and President.
I agree to the terms and conditions stated above
*
Human Validation
Check The Box
*
Human Validation Failed, Please Try Again
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