MINISTRY OF SPORT & YOUTH AFFAIRS In collaboration with SanKofa HP

1st ANNUAL CARIBBEAN SPORT PSYCHOLOGY CONFERENCE REGISTRATION FORM

MAY 26-28, 2011

NAME: __________________________________________________________________ ___ Athlete ___Coach ___Sport Officer ____Administrator ____Other

ADDRESS: __________________________________________________________________ ______________________________________________________________________________ PROFESSIONAL AFFILIATION: ________________________________________________ ______________________________________________________________________________ EMAIL: __________________________________________________________________ TELEPHONE: _________________________(Cell) ________________________ (Other)

FOR OFFICIAL USE ONLY