Coach Registration – Swimming Canada

* Phone

* Cell Phone

* Email

* Confirm Email

* Preferred Language

English French

Group

Canadian Forces RCMP Aboriginal Ancestry Physical Disability

Highest Level of Education

Secondary College/CEGEP University

What club do you coach with?

* Coaching Experience

* Describe the swimmers you coach

* Contact in case of emergency

* Emergency contact telephone

* Allergies or medical concerns affecting participation in the course

* Do you require special accommodation?

* I understand that I will be video taped during the course. This video is for your educational purpose during the course. Your coaching video may be used for training of NCCP Learning Facilitators or Coach Evaluators in the future.

Yes No

* Swimming ability

Strong swimmer Deep water unsafe

* required