This training manual was developed as part of the Clinical Breast Cancer Paddling Coaches Training Camp to support coaches working with breast cancer survivor (BCS) paddlers. It provides practical, evidence-based guidance on adapting technique, managing health considerations, and creating safe, inclusive, and empowering training environments. With contributions from guest coach Kamini Jain and real-life case studies, the manual equips coaches with the tools to lead with empathy, foster resilience, and ensure that all paddlers — regardless of physical ability or treatment history — can thrive on the water.