Coach Reimbursement (Northumberland Minor Hockey)

Print Coach Reimbursement

This form is for all Northumberland Minor Hockey REP, House League and Select bench and on-ice helpers for certification reimbursement. **** Please submit a new form for each course taken **** ONLY SUBMIT ONCE YOU HAVE PASSED THE COURSE **** Reimbursement will be made once you are rostered to a team or added to our volunteer list **** Reimbursement is for course fee only ****

REQUIRED ITEMS:

Coaches: Coach certification, Respect In Sport Activity Leader, Gender Identity and Expression Course, Valid Police check/Declaration
(the coach certification required will vary depending on the level of hockey you are coaching)

Trainers: Trainer Certification, Respect In Sport Activity Leader, Gender Identity and Expression Course, Valid Police check/Declaration

Managers: Respect In Sport Activity Leader, Gender Identity and Expression Course, Valid Police check/Declaration

On-ice Volunteer: Respect In Sport Activity Leader, Valid Police check/Declaration
(for practices only....you may not participate on the bench during a game)

OMHA Site: Coaches
OMHA Site: Trainers

Contact Information

First and Last Name^*
Address^*

Number / Street Name
City^*
Postal Code^*

A1B2C3
Contact Number^*

Example: ###-###-####
Email Address^*

Example: [email protected]

Team Information

Which team are you requesting this for?

Select Your Team^*
Position on Team^*

Coach, Trainer, Manager

Clinic Information

Enter Information for the clinic attended

Type^*

Police check, Trainer, Coach, Respect In Sport
Fee^*

Enter the amount of the fee for this certification
Clinic Location^*

Clinic Date^*

Open the calendar popup.

Attachment

Receipt & Certification Attachments

Please attach scanned copy of receipt^*

Allowed extensions: .jpeg, .jpg, .png, gif, .pdf, .doc, .docx.
Maximum # Files: 5. Maximum File Size: 4MB.
Please attach scanned copy of certitication^*

Allowed extensions: .jpeg, .jpg, .png, gif, .pdf, .doc, .docx.
Maximum # Files: 5. Maximum File Size: 4MB.