Bruins Camp Registration

Bruins Camp Registration
Athlete Information
Athlete's Name*

First NameLast Name
Position*
Graduating Year*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Parent/Guardian Information
Name*

First NameLast Name
Cell Number*
E-mail*
example@example.com
Emergency Information
Emergency Contact's Name*

First NameLast Name
Relationship*
Phone Number*
Does the athlete have any allergies, chronic illness, or medical conditions? If yes, please describe.
Is the athlete prescribed an inhaler? If yes, please explain any instructions.
Confirmation of Payment

THIS SIGNATURE AKNOWLEDGES MY UNDERSTANDING AND GUARANTEE THAT I WILL BRING A CHECK OR CASH IN THE AMOUNT OF $350 THE FIRST WEEK OF BRUINS CAMP (JULY 11th OR JULY 13TH) FILLED OUT TO BLAKE LACROSSE

BY ACKNOWLEDGING AND SIGNING BELOW, I AM DELIVERING AN ELECTRONIC SIGNATURE THAT WILL HAVE THE SAME EFFECT AS AN ORIGINAL MANUAL PAPER SIGNATURE. THE ELECTRONIC SIGNATURE WILL BE EQUALLY AS BINDING AS AN ORIGINAL MANUAL PAPER SIGNATURE.
Signature*

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Athlete Information