Declaration of Interest for District Coaches and Team Managers for the
2016 Saskatchewan Summer Games
Estevan – July 27th – 30th, 2016
Forms Due January 4, 2016
Name: _______________________________________________________________________
Address: _______________________________________________________________________
Email: _____________________________________ Phone: _____________________________
SHF #: __________________________________
District (formerly known as Zone) of Residence: (Circle one)
1-South East (Weyburn, Estevan area)
6-Saskatoon Sport
2-Regina Sport
7-Rivers West (N Battleford, Lloyminster, Meadow Lake area)
3-South West (Moose Jaw, Swift Current area)
8-Lakeland (Prince Albert, Melfort, Nipawin area)
4-Parkland Valley (Yorkton, Melville area)
9-Northern (La Ronge area)
5-Prairie Central (Humboldt area)
CAC Coach Certification Level: (Please circle) IOB
Coach 1
Coach 2
Comp Coach
None
Certification Discipline: (Please circle) English Western
Have you been involved in past Games? Yes No Sport: ____________________________
Do you have students interested in qualifying as Summer Games Athletes? Yes
No
Do you have specific knowledge/background that you feel adds to your qualification as a Summer
Games Coach or Manager?
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
What makes Summer Games an exciting and positive opportunity for Athletes and Coaches?
_________________________________________________________________________________
Kylie Rae Dahlstrom - Technical Administrator
2205 Victoria Avenue Regina, SK S4P 0S4
Tel: 306-780-9490 Fax: 306-525-4009
Email: [email protected]