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2009-2010 Coaching Application

If you'd like to coach a RAHA team, please fill out the following form.

Name
Address
City
Zip Code
Phone Number (home)
Phone Number (work)
Email Address

Level certified to coach
Expiration date
Coaching experience
Playing experience and where
Team desiring to coach
Do you have a child registered in RAHA?		Yes No
Coaching level desired		Head Coach Assistant Coach
If you wish to coach your child's team, what level will they play this season?		Junior Gold U16 Boys Bantam Peewee Squirt Girls U14 Girls U12 Girls U10 Initiation Program
Additional Info/Comments
Enter following code
		The RAHA Registrar must have a front/back copy of current coach's card on file prior to any on or off ice coaching.