Child's Name:
Gender: - Please Select - Male Female
Date of Birth: - Month - January Februrary March April May June July August September October November December - Day - 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 - Year - 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993
Address: ,
Home Phone:
Work Phone:
Name:
Email:
Cell Phone:
Register as: Skater Goalie Split (3 Skater Sessions, 3 Goalie Sessions)
Current Team:
Highest Level Played: House Select A AA AAA Club JV Varsity
Please Select Your Division 8 and Under 12 and Under 18 and Under
Position
Cost
Skater
$100
$60
$80
Date
8 and Under
12 and Under
18 and Under
March 25, 2012
5:00PM - 5:50PM
6:00PM-6:50PM
7:00PM - 7:50PM
April 15, 2012
April 29, 2012
May 5, 2012 (Saturday)
May 12, 2012 (Saturday)
