Private Sessions Request Form
*Please note appointment is not considered confirmed until you receive an email confirmation from us.
Parent Name
*
Mr.
Mrs.
Miss.
First Name
Last Name
Participant Name
*
First Name
Last Name
Current Level
*
Please Select
AAA
AA
A
Select
Most recent level played
Frequency
*
Please Select
Once in a while
Weekly
Bi-weekly
Multiple times per week
How often are you looking to attend private sessions
Age
*
Year of birth of participant
Contact Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email Address
*
example@example.com
What date and time work best for you?
*
Any other specific date and time, if the above selection is not suitable.
*
-
Month
-
Day
Year
Date
Hour Minutes
AM
PM
AM/PM Option
Please provide us with any details you feel are important for us to know
Would you like to be notified about promotional services?
*
Yes
No
Please choose locations that will work for you to attend the private session.
*
Scotia Pond
Paramount Rink
Emery rink
Book your own ice
Submit
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