BERTI HOCKEY REGISTRATION FORM

BERTI HOCKEY REGISTRATION FORM

(Please note this form may not display correctly on mobile)
Player Name *

First Name Last Name
Birth Date *

Month Day Year
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
Position (full equipment is required) *

Skater Goalie (FREE)
Minor Hockey Experience *

1-2 years 2+ years
Which camp are you registering for? *

U9 Basic Skills ($40/skater, 2 sessions*) U11 Basic Skills ($20/skater, 1 session*) U13 Basic Skills ($20/skater, 1 session*)
Payment method (payment required before first session)

e-Transfer (to bertihockey@gmail.com) Cheque (payable to Bastien Berti) Cash
Parent/Guardian Name *

First Name Last Name
Phone Number *

Area Code Phone Number
E-mail *
Questions or comments
Thank you for registering, I will reach out via email with confirmation. *Previous sessions canceled due to COVID
Should be Empty:

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