2023-2024 Bench Staff Application (BLOMHA)
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2023-2024 Bench Staff Application
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2023-2024 Bench Staff Application
This application is for REP MD, House League Select and House League team volunteer positions including on-ice volunteers.
Applicant Information
YOUR Name
*
YOUR Date of Birth
*
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Street Address
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City
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Postal Code
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Email address
*
Example: yo
[email protected]
. Your submission will be sent to this address.
Phone Number
*
Example: ###-###-####
Position + Level Applying
PLEASE NOTE THAT THE INITIATION PROGRAM ONLY REQUIRES ASSISTANT COACHES.
Level
*
Initiation/House League
House League SELECT
REP MD
TEAM POSITION
*
Head Coach
Assistant Coach
Trainer
Manager
Parent Rep
On-Ice Helper
CHECK ONLY ONE
Volunteer Experience
Have you volunteered with BLOMHA previously?
*
Yes
No
In what capacity?
*
Head Coach
Assistant Coach
Trainer
Manager
Parent Rep
On-ice Helper
CHECK ALL THAT APPLY
Other Organizations?
LIST ORGANIZATIONS AND CAPACITY
Current Certifications
House League ASSISTANT COACH minimum requirements: U8 Minor Novice & U9 Novice must have Coach 1 - Intro to Coach | U10 Minor Atom and above no NCCP is required (optional) | TRAINERS must have a valid HTCP Level 1 certification prior to the start of the season | ALL BENCH STAFF must have completed the online courses for Respect in Sport for Activity Leaders and Gender Identity and Expression prior to the start of the season | ALL BENCH STAFF must have valid Police Clearances (2018 or newer)
Hockey Canada Certification
*
Coach 1 - Intro to Coach (not required but preferred for Initiation Program)
Coach 2 - Level 2
Development 1 Trained
HTCP Trainer Level 1 (completed in 2020, 2021, 2022)
Respect in Sport for Activity Leaders Certificate
Gender Identity + Expression Certificate
HU - Safe Return to Hockey
None
CHECK ALL THE CERTIFICATIONS YOU CURRENTLY HOLD.
Police Clearance
*
Yes (2020 or newer)
No, I will apply immediately upon my acceptance to a team
Team Selection
Please select a second choice for a division you would be willing to assist.
I have a child in the division I am applying for:
*
Yes
No
Name of your child(ren) in division(s) you are applying for
*
First Choice
*
Select One...
U6 Initiation 4/5 (2018-2019)
U7 Initiation 6 (2017)
U8 Initiation 7 (2016)
U9 Novice (2015)
U10 Minor Atom (2014)
U11 Atom (2013)
U12 Minor Peewee (2012)
U13 Peewee (2011)
U14 Minor Bantam (2010)
U15 Bantam (2009)
U16 Minor Midget (2008)
U19 High School (2004, 2005, 2006)
Divisions are composed of separate age groups.
Second Choice
Select One...
U6 Initiation 4/5 (2018-2019)
U7 Initiation 6 (2017)
U8 Initiation 7 (2016)
U9 Novice (2015)
U10 Minor Atom (2014)
U11 Atom (2013)
U12 Minor Peewee (2012)
U13 Peewee (2011)
U14 Minor Bantam (2010)
U15 Bantam (2009)
U16 Minor Midget (2008)
U19 High School ( 2005, 2006,2007)
Please indicate if there is another division you would like to assist.
Indicate if there is a particular Head Coach you would like to assist
*
If accepted to a BLOMHA House League team/bench staff position I agree to abide by the BLOMHA Constitution & By-Laws, Rep MD and House League Select Policies and any other directives that the House League Committee may issue.
I agree to submit a Police Vulnerable Sector Record Check, upgrade my certifications if required and complete all other certificates as stipulated above.
I agree that all certifications will be completed within two weeks of acceptance of as part of a team/bench staff.
I certify that my answers are true and complete. I understand that false or misleading information in my application may result in my release from a team.
I agree to the terms and conditions stated above
*
Human Validation
Check The Box
*
Human Validation Failed, Please Try Again