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? *

U11 August Tryout Prep Camp ($90/skater for 3 sessions) U13 August Tryout Prep Camp ($120/skater for 4 sessions)
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. Refunds available until July 31st, 2022.
Should be Empty: