Elliot Lake Wildcats Evaluation Camp

Elliot Lake Wildcats Evaluation Camp

Please fill in the form below.
Player Name*

First NameLast Name
Birth Date*

MonthDayYear
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
ForwardDefenseForward or DefenseGoalie
RightLeft
Height*
6'2''
Weight*
195 lbs
Citizenship*
Toronto/Canada
Name of 2019-20 registered team and league*
Player email*
example@example.com
Player Number*

Area CodePhone Number
Dad's Name*

First NameLast Name
Phone Number*

Area CodePhone Number
Mom's Name*

First NameLast Name
Phone Number*

Area CodePhone Number
E-mail*
Any Medical Conditions we should be aware of?
Health Card #
Emergency Contact Name*
Emergency Contact Number*

Area CodePhone Number
YesNo thanks, I'm only here for the skateNot sure yet
Payment of $250 (incl. HST) must be included with registration form submission.

E-transfer to: toewhite@hotmail.com

* Please list players name in the message box on e-transfer

Any questions please contact:

Taurean White

Head Coach/GM Elliot Lake Wildcats

cell: 613-608-7124

e-mail: toewhite@hotmail.com
Cancellation Policy: NO REFUND will be provided if application is cancelled within 2 weeks of camp date. A $75 processing charge applies otherwise.
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