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Email: *

Date of Birth: *

Medical alert if any: *

Phone: (please provide 2 numbers) *

Name of Player: *

Position: *

Division played: *

Address: *

Height and Weight: *

Name of Parent/Guardian: *

I declare that I release Fleming's Hockey Skills Camp and all staff from all responsibility for any claims, costs, or actions as a result of any injury, loss or damage while attending this camp *

For team discount, please list teammates:

Province and Postal Code: *

e-transfer:

Fleming Hockey Skills Camp flemingchrissy@hotmail.com

City: *

Tier: *

Years in hockey: *

Gender: *

Fleming Hockey Skills Camp

Got a Question?

Please don’t hesitate to contact us if you have any questions or comments.

Registration

Complete this form and send with payment to:
Fleming Hockey Skills Camp
Attention: Christine Fleming

Box 126

Smoky Lake, AB

T0A 3C0

Phone: 780 656 2457

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Got a Question?

Registration

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