Registration Form
Player Name
First Name
Last Name
Current Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Birth Year
Please Select
2006
2007
2008
2009
2010
2011
2012
Birth Country
Birth City
Future’s Camp
Please Select
Seattle
Gender
Please Select
Male
Female
I prefer not to specify
Position
Please Select
Forward
Defence
F/D Forward and Defence
Goalie
Shoots/Catches Right or Left
Please Select
R - Player
L - Player
R - Goalie(Catches)
L - Goalie(Catches)
Current League
Current Association
Current team
Emergency Contact Name
First Name
Last Name
Emergency Contact Phone Number
Please enter a valid phone number.
Parent Guardian Information
(This contact information will be used when we send further information about evaluation camp schedules for your son or daughter as well as any other pertinent information regarding evaluations.)
Full Name - Primary Contact Person for Camp Communication
First Name
Last Name
Parent/Guardian Primary Contact Phone Number
Please enter a valid phone number.
Primary Contact Email Address
example@example.com
Parent/Guardian 2
First Name
Last Name
Phone Number
Please enter a valid phone number.
Email
example@example.com
Please select age group for Athlete and any optional services.
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16U Group
$
499.00
Credit Card Details
First Name
Last Name
Credit Card Number
Security Code
Card Expiration
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