Volunteer Coach Form Volunteer Coach Form Name* First Last Resident of Châteauguay?*YesNoAddress* Street Address Address Line 2 City AlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland & LabradorNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon Province Postal Code Email* Enter Email Confirm Email Phone NumberCell Phone NumberWork Phone NumberMedical conditions / Allergies Years of coaching123456789101112More then 12Équipe souhaitée / Team of interest*Pre-Novice Ligue maison / House League Pre-NoviceNovice Ligue maison / House League NoviceMini Ligue maison / House League MiniBenjamin Ligue maison / House League BantamCadet-Juvénile Ligue maison / House League Midget-JuvenileMini Inter-cités / Mini Intercity BOYSMini Inter-cités / Mini Intercity GIRLSBenjamin Inter-cités / Bantam Intercity BOYSBenjamin Inter-cités / Bantam Intercity GIRLSCadet Inter-cités / Midget Intercity BOYSCadet Inter-cités / Midget Intercity GIRLSJuvénile Inter-cités / Juvenile IntercityLa rôle d'assistant ou d'entraîneur-chef sera déterminé par l'association. Position of assistant or head coach will be determined by the association.Grandeur chandail / Shirt size*Specify if it's Men or Women size, youth or adult.Grandeur pantalon ou short / Pant or short size*Specify if it's Men or Women size, youth or adult.Availibilities*Monday nightTuesday nightWednesday nightThursday nightFriday nightNever. I'm always available.When aren't you available to coach? Please note that it is mandatory to be available during weekend to be able to coach a team.Child 1 Name First Last CBA Division of Child 1Pre-NoviceNoviceMiniBantamMidget/JuvenileTeam played for last season - Child 1Date of birth - Child 1 MM DD YYYY Age - Child 1Leisure Passport #, expiry date (mm/dd/yyyy) - Child 1Medicare #, expiry date (mm/yyyy) - Child 1Medical conditions / Allergies - Child 1 School and Grade - Child 1Child 2 Name First Last CBA Division of Child 2Pre-NoviceNoviceMiniBantamMidget/JuvenileTeam played for last season - Child 2Date of birth - Child 2 MM DD YYYY Age - Child 2Leisure Passport #, expiry date (mm/dd/yyyy) - Child 2Medicare #, expiry date (mm/yyyy) - Child 2Medical conditions / Allergies - Child 2 School and Grade - Child 2Child 3 Name First Last CBA Division of Child 3Pre-NoviceNoviceMiniBantamMidget/JuvenileAge - Child 3Team played for last season - Child 3Date of birth - Child 3 MM DD YYYY Leisure Passport #, expiry date (mm/dd/yyyy) - Child 3Medicare #, expiry date (mm/yyyy) - Child 3Medicare #, expiry date (mm/yyyy) - Child 3Medical conditions / Allergies - Child 3 School and Grade - Child 3