Mixed Ability Sport Coach Certification

(she/her, he/him, they/them)

Please note that your Coach Certification number is required for Coaches Association of Ontario Professional Development points. This clinic has been assigned 3 PD points.

Saturday January 21, 2023 from 10am-3pm at Guelph Collegiate Vocational Institute (155 Paisley St, Guelph, ON N1H 2P3)

Abilities Centre is committed to protecting the privacy of its members. Abilities Centre staff treat the personal information of individuals participating in the Abilities Centre programs as confidential and share such information only as required by law or for consistent purposes as outlined in the Freedom of Information and Protection of Privacy Act. Individuals have a right to know how their information has been used and to whom their information has been disclosed. Personal information about individuals participating in the Abilities Centre programs are used for the sole purpose of facilitating the programs. It is treated as confidential, securely stored, and is accessible to and shared amongst Abilities Centre staff only on a need to know basis. By clicking the box, and in consideration of my (or my son/daughter's) participation in Abilities Centre programs, I consent and authorize Abilities Centre to collect data through surveys and questionnaires with de-identified identification number provided by Abilities Centre (to ensure confidentiality). All information is collected for the purpose of Abilities Centre evaluation. All information that is collected is kept private and confidential, entered into a computer database and stored in a locked office on a password protected laptop accessible only by Abilities Centre program staff and research team. No identifying information, such as your (or their) name, will appear in the database. All the data will be aggregated to further protect the confidentiality of your (or their) responses.

By checking the box, I hereby grant and release to Abilities Centre the right to use photographs, audio tapes and/or videotapes in which I or the participant appear in any information, promotional and/or marketing materials such as videos, films, recordings, still photographs, digital images, social media (Facebook, Twitter, You Tube, Instagram, etc.) or articles relating to Abilities Centre, its programs and services including but not limited to, membership brochures, newsletters, annual reports or our website, whether broadcast on television, radio or any other medium. In the event that these images are to be used for any other purpose by Abilities Centre that is inconsistent with the purposes outlined above, it is understood and agreed that my prior consent shall be obtained.

Please note that while we are happy to provide at home resources for continued physical activity at home, you are performing these activities at your own risk. For any programming specific to physical activity, please do not participate in these activities if you are injured, sick, dizzy, short of breath or are experiencing any other health related issues. The contents of this video are intended for Abilities Centre registered participants and should not be used by anyone not registered within the program. Abilities Centre will not be responsible or liable for any injury or harm you sustain as a result of our programming. Prior to starting exercise, it is your responsibility to ensure your activity area is free from obstacles or debris to ensure your safety during the activity. Participants 12 years of age or younger should obtain permission from, and be supervised by a parent/guardian prior to and during participation. By clicking the box, I acknowledge and agree to the statements made above.

As part of the program evaluation process, we will be tracking participants’ attendance in the program. All information collected will be de-identified, meaning the participant’s name will be removed. The information will be stored on a password-protected computer. Only necessary Abilities Centre staff involved in the program will be able to access the information. This information will only be shared in summary form in reports. Collection of this information is necessary to run programming; however, we are happy to discuss this process further with you if you have questions. Please check one of the boxes below to indicate your response.

Part of the evaluation process also involves collecting information from program participants about their experience in the program. This may involve surveying the participants about their experience in the program, interviewing participants about their experiences in the program, observing individuals participating in the program (e.g., to assess the level of engagement, development of relevant skills, etc.) and/or any other activities that might provide participants with an opportunity to communicate their experiences in the program. Participation in these evaluation activities is voluntary and you can withdraw your consent to participate in the evaluation at any time by emailing research@abilitiescentre.org or telling any Abilities Centre staff involved in the program you are participating in. Your or the participant’s involvement in the program will not be affected; you/they will be free to participate but their information will not be recorded.

If you/they choose to participate in the evaluation, you/the participant’s information will be protected. All information collected will be de-identified, meaning your/their name will be removed and an anonymous code will be used. Individual responses will not be made public, but the aggregated data will be included in reports and used in quality improvement research. The information will be stored on a password-protected computer. Only necessary Abilities Centre staff involved in the initiative will be able to access the information.

Throughout your time in Abilities Centre programs, there may be some opportunities to share experiences by doing interviews or sharing testimonials. For these opportunities, we may ask to share your personal reflections on your experiences in the programs and possibly your name. Providing this information will identify you to the public. This information is sometimes shared by Abilities Centre on social media, on our website, or in reports. The goal is to share what is happening with Abilities Centre programs with other people. Abilities Centre will only share your name or your words with your permission. Before sharing your information, an Abilities Centre staff will reach out to you to verify your consent to have this information shared.

If you would like to share your experiences in Abilities Centre programming and select "yes' below, please provide an email address or phone number below where an Abilities Centre staff can contact you for permission to share your testimonials.

You can take back consent at any time by emailing research@abilitiescentre.org or telling any Abilities Centre staff involved in the program you are participating in