Please ensure your deposit for the camp is paid before submitting this form.
More Information

 

Please fill out one form for each person attending.

Email Reference *
Please enter the email address used during payment.
 
First Name *
 
Last Name *
 
Date of Birth *
 
Height (approx.)
 
Weight (approx.)
 
Position *
 
Alternate Position
 
Highest Level Played or Coached
 
Significant Injuries / Medical History
Email *
 
Emergency Contact Name *
 
Emergency Contact Address *
Emergency Contact Phone Number *
 
Emergency Contact Relationship *
 
Any other health conditions and/or dietary requirements
Declaration *