FORT SMITH 2026 HOCKEY CAMP
Player Name
*
First Name
Last Name
Birth Date
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Parent/Guardian Name
*
First Name
Last Name
Parent/Guardian Email
*
example@example.com
Parent/Guardian Mobile Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Emergency Contact Name
*
First Name
Last Name
Emergency Contact Mobile Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Fort Smith Minor Hockey Member
*
Yes, I'm a member of Fort Smith Minor Hockey
No, (Please answer the below question)
Non Members Only: What association are you registered with?
*
AGE (2026-27 Division Chart - Age on Dec. 31st 2026)
*
U7 - (2020-2021 Born)
U9 - (2018-2019 Born)
U11 (2016-2017 Born)
U13 (2014-2015 Born)
U15 (2012-2013 Born)
U18 (2009, 2010, 2011 Born)
Fury Female Team
Other
What is your preferred Player Postiton
*
Please Select
Forward
Defense
Forward/Defense
Goalie
Health Card Number
*
Any Medical or Allergy Issues
*
Yes
No
Epi-Pen (Type where it is stored below)
Medical Alert ID
Other
If Yes, Please provide more details regarding Medical Issues
*
Epi-Pen Location
*
SPORTS WAIVER (PLEASE READ CAREFULLY AND ELECTRONICALLY SIGN BELOW
Signature
Submit
Submit
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