Registration Form

Facey Fall Camp Registration 2010

Please complete all fields, if a field does not apply to you simply type in N/A.
Medical form and $40.00 registration fee required before student is eligible to participate in contact practice.

First Name:
Last Name:
Mailing Address:
City:
Province:
Postal Code:
Phone number 1:
Phone number 2:
Player Cell:
Parent Email:
Parent Email 2:
Player Email
Height in feet and inches
Weight in pounds
Birthdate
Grade in September, 2010
Medical History - Details