Coach Clinic Reimbursement (Clarington Thunder Hockey League)

Print Coach Clinic Reimbursement

This form is for CRHL team staff for certification reimbursement. **** ONLY SUBMIT ONCE YOU HAVE PASSED THE COURSE ****

Personal Information

Please ensure all contact information is current. This information will be used to mail reimbursement cheques. ALL CHEQUES WILL BE ISSUED AFTER ROSTERS ARE OMHA APPROVED.

First and Last Name^*
Address^*

Number/Street name
City^*
Postal Code^*

A1B2C3
Contact Number^*

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

Example: yo[email protected]. Your submission will be sent to this address.

Team Information

Which team are you requesting this for?

Division^*
Team Number^*
Position on team^*

Clinic Information

Course Name ^*
HU - Coach 1/Coach 2
Coach 1 - Intro to Coach
Trainer - HTCP
Respect in Sport - Activity Leader
HU-Checking
Coach 2 - Coach Level
Check All That Apply
Fee^*

Enter the total amount being reimbursed

Attachment

Receipt Attachment

Please attach scanned copy of receipt(s)^*

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

Human Validation

Check The Box ^*

Coach Clinic Reimbursement (Clarington Thunder Hockey League)

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