NORTH IOWA BULLS PRE-DRAFT CAMP
CHICAGO (BENSONVILLE), ILLINOIS: MAY 31-JUNE 2 || THIS CAMP IS NON-REFUNDABLE
USA HOCKEY
USA HOCKEY CERTIFICATION
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USA HOCKEY NUMBER
*
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PLAYER INFORMATION
NAME
*
First Name
Last Name
PLAYER PHONE (HOME)
*
Please enter a valid phone number.
Format: (000) 000-0000.
PLAYER PHONE (CELL)
*
Please enter a valid phone number.
Format: (000) 000-0000.
PLAYER EMAIL
*
example@example.com
PLAYER BIRTHDAY
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
GENDER
*
MALE
FEMALE
OTHER
HEIGHT
*
Please Select
5'4
5'5
5'6
5'7
5'8
5'9
5'10
5'11
6'
6'1
6'2
6'3
6'4
6'5
6'6
6'7
6'8
6'9
WEIGHT
*
POUNDS
SHOOT/CATCH
*
LEFT
RIGHT
POSITION
*
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FORWARD
DEFENSE
GOALTENDER
CITIZENSHIP
*
COLLEGE COMMITMENT (IF APPLICABLE)
GAMES (PREVIOUS SEASON)
*
GOALS/GAA (PREVIOUS SEASON)
*
ASSISTS/SV% (PREVIOUS SEASON)
*
PIM
*
POINTS
*
LAST TEAM
*
LAST TEAM, HEAD COACH
*
First Name
Last Name
HIGH SCHOOL
*
GPA
*
ADVISOR/AGENT NAME (IF APPLICABLE)
First Name
Last Name
ADVISOR/AGENT PHONE (IF APPLICABLE)
Please enter a valid phone number.
Format: (000) 000-0000.
ADVISOR/AGENT EMAIL (IF APPLICABLE)
example@example.com
HOME ADDRESS
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
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INSURANCE & MEDICAL CONTACT INFORMATION
*19* AND UNDER MUST BE COMPLETED BY A GUARDIAN
SAVE AND FILL OUT
CONSENT TO TREAT, PLEASE UPLOAD THE ABOVE DOCUMENT
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COPY OF INSURANCE (FRONT & BACK)
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CONSENT TO TREAT: I/WE HAVE READ, UNDERSTAND AND AGREE TO COMPLY WITH THE CONSENT TO TREAT AS OUTLINED ABOVE.
*
YES
NO
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CONSENTS
NORTH IOWA BULLS CODE OF CONDUCT, PLEASE UPLOAD THE ABOVE DOCUMENT
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CODE OF CONDUCT AGREEMENT: I/WE HAVE READ, UNDERSTAND AND AGREE TO COMPLY WITH THE USA HOCKEY CODE OF CONDUCT AS OUTLINED ABOVE.
*
YES
NO
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WHO REFERRED YOU TO THIS CAMP?
Please Select
Marquise Cotten
Nick Bruneteau
Tommy Adams
Mark Hicks
My Products
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North Iowa Bulls Pre-Draft Camp (Chicago, IL)
CHICAGO (BENSONVILLE), ILLINOIS: MAY 31-JUNE 2 || THIS CAMP IS NON-REFUNDABLE
$450.00
$
450.00
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