Christmas Bantam/Midget Registration

Christmas Hockey Camp - 2011

Bantam/Midget

Monday December 27 - Thursday December 29 from 1:15 pm to 2:45 pm
Friday December 30 from 11:00 am to 1:30 pm
Crowchild Twin Arena

Player Information Form

SKU	2011chris02

Personal Information

E-Mail

First Name

Last Name

Address Line 1

Address Line 2

City

Prov./State

Postal Code

Gender

Date of Birth

Phone

Primary Contact Name

Primary Contact Relation

Primary Contact Cell

Alternate Contact Name

Alternate Contact Relation

Alternate Contact Cell

Alternate Email

SAFETY

Safety Contact

Relationship

Safety Phone

Medical Conditions

Management/Treatment/Medicines

Sport Specific

Association / Organization

Other Organization (add if not listed above)

Team Level

Division

Current Position

Preferred Position

Shoots

Jersey (Optional)

Comments

Q & A

Price

$199.00

Qty

Order Checkout

Shopping Cart

Wishlist

May 2012

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Christmas Bantam/Midget Registration