2023-24 Team Personnel Information Form (Hamilton Huskies)
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2023-24 Team Personnel Information Form
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2023-24 Team Personnel Information Form
Form Re-submission Comment:
Admin Use Only
2023-24 HAMILTON HUSKIES TEAM
Please select the team you are associated with and your position on that team's staff.
2023-24 Hamilton Huskies Team
*
Select One...
U8 MD (2016)
U9 MD (2015)
U10 AA/A (2014)
U10 BB/B (2014)
U11 AA/A (2013
U12 AA/A (2012)
U12 BB/B (2012)
U13 AA/A (2011)
U13 BB/B (2011)
U14 AA/A (2010)
U14 BB/B (2010)
U15 AA/A (2009)
U15 BB/B (2009)
U18 AA/A (2007/2006)
U18 BB/B NBC (2007/2006)
DEVELOPMENT
Team Position
*
Select One...
Head Coach
Assistant Coach
Goalie Coach
Manager
Trainer
On Ice Helper
Treasurer
Dressing Room Guardian
Parent Rep
PERSONAL INFORMATION
Please enter your name, date of birth and complete address.
First Name
*
The name entered here must be the same as the name entered when registering for Certification Clinics
Last Name
*
Date of Birth
*
RadDatePicker
RadDatePicker
Open the calendar popup.
Calendar
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mm/dd/yyyy Type the date in using this format or select from the calendar. Birthdate is required when registering a coach to a roster in the Hockey Canada Registry
Address
*
City
*
City Only, Please DO NOT include Province
Postal Code
*
CONTACT INFORMATION
Please list the email addresses and phone numbers you wish to share. We must have 1 email address and 1 phone number from each staff member for communication purposes. YOU CONTROL WHAT WE MAKE PUBLIC FOR PRIVACY REASONS SO PLEASE CAREFULLY SELECT WHICH INFORMATION, IF ANY, THAT YOU WOULD LIKE TO DISPLAY IN YOUR TEAM PROFILE. A COPY OF THIS FORM WILL BE SENT TO PRIMARY EMAIL 1 AS CONFIRMATION OF YOUR SUBMISSION
Primary Email 1:
*
Confirmation of form submission will be sent to this email address
Please Indicate If You Would Like To Display Your Email PUBLICLY IN YOUR TEAM PROFILE.
*
No
Yes
Home Phone
Example: ###-###-####
Cell Phone
Example: ###-###-####
Please Indicate Which, If Any, Phone Number You Wish To Display PUBLICLY IN YOUR TEAM PROFILE
*
None
Home Phone
Cell Phone
Check the appropriate box. Phone numbers checked will appear on the Web Site. YOU MUST BE AWARE OF THE POTENTIAL FOR PHISHING SCAMS VIA TEXT WHEN YOU PUBLICLY DISPLAY A PHONE NUMBER
CERTIFICATIONS
Please insert your current level of certification in each category if applicable. All team personnel must have PRS Certification.
Hockey Canada Hockey ID
Please enter your HCR ID# if you know it
Coach Certification
*
Select One...
N/A
Coach 1
Coach 2 / Coach Level
Development 1 (D1 / DS1) Trained
Development 1 (D1 / DS1) Certified
High Performance 1 (HP 1) Trained
High Performance 1 (HP1) Certified
High Performance 2 (HP 2) Professional Development
Certification Required
Trainers Certification
*
Select One...
N/A
Level 1 HTSP
Level 2 HTSP
Level 3 HTSP
Certification Required
Trainers Date of Expiry
RadDatePicker
RadDatePicker
Open the calendar popup.
Calendar
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Please enter the date of Expiry for your Trainers Certification.
PRS - Prevention Services
*
Select One...
Speak Out
Respect in Sport (RIS) Activity Leader
Certification Required
Gender Identity and Sensitivity Modules Completed
*
Yes
No
Are You In Possession Of A Current Police Vulnerable Sector Scan (VS)
*
Yes
No
Obtained in either 2021 or 2022
Rowan's Law Acknowledgement Form continues to be a yearly requirement.
You will be directed to the Rowan's Law Acknowledgement Form upon submission of this Team Personnel Information Form where you will find the relevant links to the documents requiring review.
I understand the Rowan's Law documents are to be reviewed prior to the submission of the Rowan's Law Acknowledgement Form.
*
Human Validation
Check The Box
*
Human Validation Failed, Please Try Again