Online Registration for Summer 2013

Last Name:

First Name:

Street Address:

City:

Province/State:

Postal/Zip Code:

Parent/Guardian Name:

Home Phone:

Cell Phone:

Work Phone:

Emergency Contact Name:

Emergency Contact Phone:

Date of Birth (MM/DD/YYYY):

Age (as of July 31/13):

Position:

Years of Experience:

12/13 Level Played (i.e., HL, AA):

Email Address:

Parent/Guardian Signature:

B1 - Fun & Games On Ice (Ages 6-8)

B2 - Skating, Shooting and Scoring Full Day Camp (Ages 9-12)

B3a - Half Day - Specialized Positional Training for Defencemen

B3b - Half Day - Specialized Positional Training for Forwards

Goalie: B1 B2 B3

Men's Small

Men's Medium

Men's Large

Men's X-Large

Youth Small

Youth Medium

Youth Large

Youth X-Large

Submittal of your online or faxed registration form will only reserve your child's place in the Hockey School. This submittal form must be followed within 2 weeks with a signed copy of the form along with a deposit equal to or greater than 50% of the tuition fee and a cheque for the balance postdated for June 1, 2013. This will confirm your child's place in the selected programme(s).

Thank you for registering your child with CHI and we look forward to seeing you this summer.