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Welcome to the home of the
Hamilton Minor Hockey Initiation Program (HMHIP)
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Team Official Application
PERSONAL INFORMATION
*
First Name:
*
Last Name:
Street Address:
City:
Province:
Postal Code:
Home Phone:
Cell Phone:
Email:
Birthdate:
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TEAM SELECTION
Hockey School:
Head Coach
Assistant Coach
Trainer
Pre-Novice:
Head Coach
Assistant Coach
Trainer
List names of other co-team officials:
If your choice is not available will you accept a different position?:
Yes
No
Enter your second choice of positions:
CERTIFICATION
If you already have certification(s) please enter the details below.
If not, you must forward your certificate numbers as soon as they are acquired.
Expired certification must be updated as required.
Respect in Sport (Activity Leader) Number:
Coach Certification Number:
Trainer Certification Number:
Gender Identity and Expression Date Completed:
Concussion Awareness Date Completed:
Police Check Declaration Date:
Police Check Date (must be verified by HMHIP):
WAIVER INFORMATION
I understand that in order for my application to be considered, I must obtain a PRC (Criminal Reference Check - Vulnerable Sector Screening)
*
I agree and will abide by the Hamilton Minor Hockey Council Code of Conduct
*
* indicates required fields
