Name of Athlete *

Athlete's Phone *

Athlete's Email *

Gender * Male Female

Address * Address 1 Address 2

Country

Name of Parent/Guardian 1 *

Parents/Guardian 1 Phone *

Parent/Guardian 1 Email *

Name of Parent/Guardian 2

Parents/Guardian 2 Phone

Parent/Guardian 2 Email

Athlete's Date of Birth *

Athlete's Age on the 1st Day of Camp * *Years, Months, Days

Please indicate age of athlete * Age 9-11 Age 12-13 Age 14-16

Position * Check all that apply Center Left Wing Right Wing Left Defense Right Defense Goalie

Shooting Hand * Right Left

Number of Years In Organized Hockey * *Please note most recent organization name, age division, and level of hockey

Number of Years on a Hockey Travel Team * *Please note most current team, age division, and level of hockey

Name of Current Coach * *If available, contact information is appreciated

Height of Athlete *

Weight of Athlete *

Shirt Size * *Please note: The shirt size you choose will be the given size, and there may not be enough extras to substitute sizes. Youth XS Youth S Youth M Youth L Youth XL Adult XS Adult S Adult M Adult L Adult XL Adult XXL

Shoe Size * *Please note athlete's anticipated shoe size at the time of camp. For more accurate sizing, please include a current foot measurement in centimeters.

Medications * *Please list all OTC and Rx medications with dosage + schedule of when they are to be taken

Allergies* *Please list all allergies (even if mild) with a brief description of prior reactions

Roommate Request * *Both parties must request each other, or the request will not be considered.
*We must limit this to one request per camper.
*Roommates must be in same age division. If they are not, please note the higher level player may need to play down.

Is the athlete part of a team or group of more than 2 campers? * *If yes, please note which group the athlete is with as well as the names of the other campers in the group (if possible).

Other *Please use this space to tell us anything else you would like us to know.

Emergency Contact * *Before choosing an emergency contact, please ensure they will be available while the athlete is at camp.

Emergency Contact's Phone *

Emergency Contact's Email *