Sport Club Registration Form

Sport Club Information

Sport Club Name*

District*

Community Name*

Sports*

Program Level*

Program Age Group*

Program Type*

Sport Club Lead Volunteers Contact Information

Email to send New Club registration confirmation*

Please Note: If the Club manager or Head Coach named below is not currently a registered volunteer, they must register as a Volunteer and submit a Police Reference Check before they are able to participate in any program.

Club Contact Registration Number

Club Contact Name

First Last

Club Manager Registration Number:

Club Manager Name

First Last

Head Coach Registration Number:

Head Coach Name

First Last

Facility Information

Facility Name

Facility Address:

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Training Days and Time

Please indicate Sport Club practice day/days & start and end time

Select Days

Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday

Start Time

:

End Time

:

Program Session Start Date*

Program Session End Date*

Other Information

Sport Club Ability Levels

“A” Level
“B” Level
“C” Level
“D” Level

ADAPT Component

Yes
No

Registration Costs

Other Notes

Sport Club Registration Form