Clinic Hosting Application Form

Host Association

Clinic Hosting Application Form

Home Phone Number

Contact Name

Cell Phone Number

Please review Clinic Hosting Guidelines before submitting this application.

Email Address

Type of Clinic

Coaching Clinic

Officiating Clinic

Prevention in Motion Clinic

Proposed Clinic Dates

Should your first option not be available (due to facilitator/instructor limitations or date conflicts), please select an alternative date. Please include start and end times.

Option #1

Option #2

Have you already booked (or have conformation of availability) of the facility requirements, such as meeting room or ice bookings?

Thank you for your interest in hosting a clinic in BC. The BCRA VP or BCRA Technical Director will contact you shortly to make further arrangements.

Facility Name:

Address:

City:

Capacity (maximum course registrations):

Additional Comments (including ice times, arena location, etc.)

Facility Details

Athlete Development Clinic