Officials Online Clinic Reporting Form

This form is to be used only by Officals taking Online Clinics. Do not use to report historical clinics.

Clinic Instructors are to use the Sign-In Sheet available here: http://www.swimalberta.ca/officials/clinics

Your Information

First Name

Last Name

What Club are you with

Hometown Tritons Swim Club

Mailing Address

City

Province

Postal Code

Phone

Please choose the gender you identify with:

FemaleMale

Clinic Information

Introduction to Swimming Officiating and Safety Marshall, Chief Timekeeper and Clerk of Course clinics are to be completed using the E-Modules and do not require reporting. Any questions speak to your Club Officials Administrator.

Date online clinic was completed (Month/Day/Year)

What Clinic did you take