ICM Tennis – Coach Assistant Pathway Registration Form
Please complete all required details. One form per person.
Personal Information
All fields below are required unless marked as optional.
Full Name:
*
First Name
Last Name
Gender
Male
Female
Other
Prefer not to share
Date of Birth: (Minimum age requirement: 16+)
*
-
Day
-
Month
Year
Age:
*
Contact Number:
*
Format: 000 0000000.
Email:
*
example@example.com
City / Province of Residence:
*
Emergency Contact Information:
All fields below are required unless marked as optional.
Full Name:
*
First Name
Last Name
Relationship to the candidate:
*
Contact Number:
*
Format: 000 0000000.
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Tennis & Coaching Background
All fields below are required unless marked as optional.
Current Tennis Playing Level:
*
Beginner
Intermediate
Advance
Do you have any previous coaching or assistant coaching experience?
*
Yes
No
If yes, please briefly explain
Why are you interested in joining the ICM Tennis Coach Assistant Pathway?
*
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Program Level Selection
All fields below are required unless marked as optional.
Please select the level you are registering for:
*
Bronze Level – 6 Months
Silver Level – 6 Months
Gold Level – 6 Months
Tuition per Level:
*
$350 + HST-GST/Months
TOTAL FEES (INCLUDING 13% HST/GST)
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My Subscriptions
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6 Months Subscription
$396.00 CAD
$
396.00
CAD
for each
month
Email
Debit or Credit Card
First Name
Last Name
Credit Card Number
Security Code
Expiration Month
January
February
March
April
May
June
July
August
September
October
November
December
Expiration Month
Expiration Year
2026
2027
2028
2029
2030
2031
2032
2033
2034
2035
2036
2037
2038
2039
2040
2041
2042
2043
2044
2045
Expiration Year
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