Please remember to save this document to your computer once you
have completed it, then attach to your renewal when prompted.
Funded by:
100-1445 Park Street, Regina, SK S4N 4C5 • Phone: 306.780.9231 •
Toll Free: 1.800.563.2555 • spra.sk.ca
Practical Hours Verification Form
Utilizing this form, please submit any hours that you may have
taught for statistical purposes. Note: For the 2020 year, the
minimum requirement of 20 practical hours has been waived.
Fill out the form using the example below as a template:
Information relating to your class schedule including dates,
hours, frequency, etc.
Print the contact person’s name and provide their contact
information, a signature is not required.
Please total number of hours at the bottom of the form.
Name of Fitness Leader:
Class Type * Course Schedule Facility Contact Person –
Signature not required
Contact Information: Phone/Email
Address
Boot Camp Jan – May 2014 26 hours Once a week
Everfit Health Club Jane Smith (123)
[email protected]
Total Hours
* Class type may include group land, aquatic or older adult
fitness classes (e.g. bootcamp, hi/lo, step,interval/circuit
training, yoga, aquatic, etc.). Note that personal training,
coaching sports teams, andteaching physical education classes do
not fall within the Scope of Practice and thus are ineligible.
Name of Fitness Leader: Total Hours: Class TypeRow1: Class
TypeRow2: Class TypeRow3: Class TypeRow4: Class TypeRow5: Class
TypeRow6: Class TypeRow7: Course ScheduleRow1: Course ScheduleRow2:
Course ScheduleRow3: Course ScheduleRow4: Course ScheduleRow5:
Course ScheduleRow6: Course ScheduleRow7: FacilityRow1:
FacilityRow2: FacilityRow3: FacilityRow4: FacilityRow5:
FacilityRow6: FacilityRow7: Contact PersonRow1: Contact PersonRow2:
Contact PersonRow3: Contact PersonRow4: Contact PersonRow5: Contact
PersonRow6: Contact PersonRow7: Contact InformationRow1: Contact
InformationRow2: Contact InformationRow3: Contact InformationRow4:
Contact InformationRow5: Contact InformationRow6: Contact
InformationRow7:
