Ice Puffins Interest

1
Parent's name:* This field is required.
First Name
Last Name
2
Email:* This field is required.
example@example.com
3
Phone number* This field is required.By entering your number, you agree to receive text message updates from Ice Puffins Youth Hockey Club. Message and data rates may apply. Reply STOP to unsubscribe anytime.
Area Code
Phone Number
4
Where do you live?* This field is required.
Please Select
Please Select
London
Middlesex County (Komoka, Kilworth, Ilderton, etc)
Strathroy-Caradoc
Other
5
Your daughter's birth year:* This field is required.
Please Select
Please Select
2016
2017
2018
2019
2020
Other
6
What are you interested in?* This field is required.Check all that apply
Fall/Winter Program
Spring/Summer Program
Occasional "Free Play" Skates
3v3 Tournaments
Volunteering or Coaching
Sponsoring
7
Tell us a bit about your child and why you're interested in Ice Puffins:* This field is required.
You can include things like hockey experience, what you're looking for in a program, etc.
Should be Empty: