Coaches Clinic Registration

DO NOT USE THIS FORM TO REGISTER FOR IMPACT CLINICS.
The clinics on this form do NOT count towards IMPACT or CAP certification

Use this form to register for the Heart of America 2014 Coaches Clinic series. All participants need to pre-register! Only register if you will attend as space is limited.

Coaches Clinic Flyer

The fee for the clinics is $75 per coach, due at the clinic. The fee is waived for all HOA coaches who can show their 2015 HOA Credentials (must be registered, background screened, Impact or CAP certified and have completed online officiating clinics).

Clinic Date & Location*

Coach Name (First Last)*

Phone (C)*

Email*

Club

Coaching Experience*

Coaching Age Group in 2015 season*

Is Coach USAV Member?*



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(*) It is required to have this information before submitting form.