*Players can register by mail or in person on August 28th. (Space permitting)Schedule will be distributed at registration
Please make cheque or money order, $175 payable to:
Kamloops Storm Hockey Club
* Please note that registrations will not be confirmed until after July 23, 2008.
Personal Information
Player's Name: ______________________ Birth date: ___________Address:_________________________________________________
City:_________________ Prov./State:___________________ Postal Code:___________________________
Phone:________________________ Fax:____________________
Parent/Guardian:______________________________________ Height:_______________ Weight:_____________________
Hockey Background
Preferred Position:____________________ Shot: Left ______ Right ______
Last Team Played For:_______________City ___________
Classification:_______________ (Bantam, Midget "AA", "AA" etc.)
Last Coach:__________________ Phone:________________ Last Seasons Stats: Goals:______ Assists ______ Penalty Mm______ Avg. ______
Sav. Per.______
Medical Information
Family Doctors Name:_______________________ Phone: ___________________
Medical Card #:______________________ Plan Name:______________________
Dental Card #: _______________________ Plan Name:______________________
Have you had any fractures, dislocations, concussions or separations in the last 24 months?
If Yes, explain:__________________________________________________________________________
________________________________________________________________________________ List any allergies you have:__________________________________
Authorization
Player's Signature: __________________________________
Parent/Guardian:__________________________________
Mail to:
Kamloops Storm Hockey Club
c/o 3-2361 Tranquille Road
Kamloops, B.C.
V2B 3N6
Tel: (250) 376-0990
Fax: (250) 376-6897
*All players must bring their own equipment.
Please note all players registered in Bantam, Midget or Juvenile during the past season must wear full face shields and a throat guard. |