CSCM Athlete Intake

Please note: This form is for Sport Canada Carded, National level athletes.

If you are a current CSCM Development level athlete, a new athlete interested in working with CSCM, or a visiting athlete, please fill out this form instead.

Please note that many fields are required. If you are having trouble submitting the form, please go back and check if you have missed any required fields. If you have checked for required fields and still cannot submit the form, please email

Upon successful submission, you will see a message indicating that your response has been received.

2023 CSCM Athlete Intake

Parent / Guardian Information

General Information

Primary Address *
Primary Address
Ex. Calgary, Alberta or Canadian Sport Centre Calgary
6-Digit Number
9-Digit Number

Emergency Contact Information

Sport Information

Ex. Soccer, Taekwondo, Diving
Ex. Diving Training Group, Rowing Manitoba Training Group, Etc.
Carding Status *
If unsure, please select 0.
If unsure, please select 0.

Game Plan

Plans for Career, Education, Personal Development, Etc.



Mental Health & Wellness

(1= Never; 3=Sometimes; 5=Always)
(1= Never; 3=Sometimes; 5=Always)
(1= Never; 3=Sometimes; 5=Always)
(1= Never; 3=Sometimes; 5=Always)
(1= Never; 3=Sometimes; 5=Always)
Example: Challenging life events, prior experience with counselling , family history of mental illness, difficult experience in sport, etc

Physical Preparation & Training History

Example (Weights, Dry-Land, Etc.)
Frequency, Training Types, Time, Etc

Current Injury Status

Please list any current injuries we should be aware of.

Injury History

Please list your past injuries.

Service Providers

Please list your primary service providers names and contact information below.
Dr. John Smith

Tell Us More About Yourself

Note - this link may be shared as part of an online CSCM bio. If you have more than one bio link, please indicate which one you prefer we share.

Social Media

Please provide us with your social media information. Instagram, Twitter, Youtube, Facebook, LinkedIn, Etc
I agree to allow CSCM to share this information.

Headshot / Photo

If you have one, please submit a recent headshot and/or action image. Please indicate whether you give CSCM permission to use these photos on the "Manitoba athletes" section of our website. Please only submit images that you have the rights/permissions to share.

Required upload size: 5MB

Required upload size: 5MB

Please indicate whether you give CSCM permission to use these photos.

Additional Information

Review & Submit

I Agree, all the information given in this application is complete and true. *
I Agree, The Canadian Sport Centre Manitoba is authorized to verify any information contained in this application. *
I Agree, to be contacted via Email, Text (SMS) , and other communication methods by the Canadian Sport Centre Manitoba. *
I Agree, the Canadian Sport Centre Manitoba is authorized to contact my coach in my respective sport. *