Private Lesson Registration
Thank you for your interest! Please fill out and submit this form with your information, and we will get in touch with available weekly slots.
Parents' Name
First Name
Last Name
Player's Name
First Name
Last Name
Email Address
example@example.com
Phone Number
Please enter a valid phone number.
Birth Year
*
YYYY
Private Sessions Offered
Please Select
Private Session (On Ice)
Film and Private
Session Type
Please Select
1-on-1
Semi
Small Group
NexLevel Privates
Please Select
Single Lesson ($250 + GST)
2 sessions ($500 + GST)
3 sessions ($750 + GST)
4 sessions ($1000 + GST)
NexLevel Privates
Please Select
Single Lesson ($325 + GST)
2 sessions ($650 + GST)
Other Player Emails
Enter additional player emails separated by commas (e.g., player1@email.com , player2@email.com
What specific skills or areas would you like the coach to focus for the player/group during this private session? (Required)
*
Additional Notes or Requests
Submit
Should be Empty: