Brave Raiders Hockey Club

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	Conditioning Skills Camp
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First Name:

Last Name:

Age: Last Team Played For:

Category

First Year

Second Year

Alberta Health Care:

Parent's/Guardian's Name(s):

Address:

Address 2:

City: Province: Postal Code:

Day Phone: Evening Phone:

Email

Alternative Parent/Guardian, if applicable

Parent's/Guardian's Name(s):

Address:

Address 2:

City: Province: Postal Code:

Day Phone: Evening Phone:

Email

Additional Information:

Hockey Player

Payment must be received by last hockey registration date - August 30th.

For Insurance purposes, Player must be registered for the 2010/2011 Hockey Season before participating in the Conditioning Camp.

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