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Participant’s Name:
__________________________________________________________________
Parent’s Name:
_____________________________________________________________________
Mailing Address:
____________________________________________________________________
__________________________________________________________________________________
Phone Number: ___________________________ Email:
__________________________________
Emergency Contact:
_________________________________________________________________
Emergency Phone Number:
____________________________________________________________
Health Card #:
______________________________________________________________________
Allergy/Medical Needs:
_______________________________________________________________
__________________________________________________________________________________
Date of Birth:
_______________________________________________________________________
Male __ Female __ Age __
Level played last season: __________________________ Position played:
_____________________
Payment:
Ages 5 & 6 ~ $120 + GST ($126 Total)
Ages 7 – 15 ~ $225 + GST ($236.25 Total)
Goal Tenders ~ $100 + GST ($105 Total)
Mail To:
On The Edge Hockey Camp
Credit Union Arena
207 Phillip Street
P.O. Box 87
Tignish C0B 2B0
*** Registration forms will be processed on a first come first serve basis
until all spaces are filled ***
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