REGISTRATION FORM

Functional Hockey Holiday Clinic
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Peewee       Bantam        Midget/Jr./College
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Please circle level

Please fill out form, select clinic level,
and click on the submit button when finished.
Name:
Address:
City and Zip:
Parents Name:
Email:
Home Phone:
DOB:
Height:
Weight:
Team:
Position:
Clinic Level:
 
Send check ($89) payable to Sportscitek to:

Bruce Turpin
5020 N. Albany Ave #2
Chicago, IL 60625
 
 
 
Pay via Credit Card or Paypal



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