NYSAHA 8U ADM SKILL DEVELOPMENT/CROSS ICE PROGRAM ASSOCIATION DECLARATION FORM

NYSAHA 8U ADM SKILL DEVELOPMENT/CROSS ICE PROGRAM ASSOCIATION DECLARATION FORM {Forms must be completed by 10/15}
Local Association Name
Section*

CentralEastNorthWest
Check One*

Tier ITier IITier IIIGirlsHouse/RecLeague
Association Mailing Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Association President's Name*

First NameLast Name
President's E-mail*
President's Phone Number*

Area CodePhone Number
ADM Program Administrator*

First NameLast Name
ADM Administraotr E-mail*
ADM Administrator Phone Number*

Area CodePhone Number
ACE Director *

First NameLast Name
ACE Director Email
example@example.com
ACE Director Phone Number*

Area CodePhone Number
List the Ice-Time by month: the ratio should be 3 practices to every 1 game played

Complete the chart below with the required information*

Answer all questions*

	YES	NO
Are you using the USA Hockey lesson plans and other teaching materials that were provided with the NYS Cross-Ice Manual?
Does Your Association host one Cross-Ice Jamboree each season?
Does your association combine with another association for cross ice hockey?
Did your Association use and explain USAH and NYS Parent Education on ADM 8u hockey?
Would your association be interested in hosting an on-ice ADM Session?
Does your Association have Cross ice Boards?
Are your cross-ice skill development practices station based?

If your association combines with another association for cross ice, list that association here.

	0-10	11-20	21-30	31-40	41-50	51- 100	101- 150	over 151
How many players are enrolled in the skill development /cross ice program?

NYSAHA 8U ADM SKILL DEVELOPMENT/CROSS ICE PROGRAM ASSOCIATION DECLARATION FORM {Forms must be completed by 10/15}