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Player Registration Form
*Form
must
be completed and payment received before athletes can participate in our camps.
*
Indicates required field
Parent or Guardian Information
Parent or Guardian's Name
*
First
Last
Address
*
Line 1
Line 2
City
State
Zip Code
Country
Email
*
Phone (day)
*
Phone (cell)
*
Emergency Contact
In case of emergency, please provide us two persons we may contact if we are unable to reach you.
Emergency Contact 1
*
First
Last
Phone Number
*
Emergency Contact 2
*
First
Last
Phone Number
*
How did you hear about the camp?
Choose One
*
Google
Flyer
Poster
Instructor or Friend
Name of Instructor or Friend
*
Please type name here.
Player Information
Gender
*
Male
Female
Name
*
First
Last
Position
*
Forward
Defense
Fwd/Defense
Goaltender
Birthday (mo/day/yr)
*
Email
*
Age
*
T-Shirt Size (included in select camps)
*
Youth Small/Medium
Youth Large/XL
Adult Small
Adult Medium
Adult Large
Adult XL
Medical Information
Are there any particular medical problems your child may be experiencing which Victory Hockey should be aware of? If yes, please explain below.
*
Skill Level
*
Beg./Intermediate
Advanced (currently play for A, AA, or AAA hockey clubs)
Camp(s) Attending
California
*
Pasadena, CA - $110 - June 24-25, 2019 - Skills
Pasadena, CA - $110 - June 26-27, 2019 - Power Skating
Pasadena, CA - $210 - June 24-27, 2019 - Power Skating & Skills
Michigan
*
Traverse City, MI - $120 - July 8-9, 2019 - Skills
Traverse City, MI - $120 - July 10-11, 2019 - Power Skating
Traverse City, MI - $230 - July 8-11, 2019 - Power Skating & Skills
List the top 3 areas/skills your child can improve on (optional)
*
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