Returning Member Application Form

Season: 2012 - 2013 Grade: First Name: Middle Name: Surname: Gender: Male Female Parent's Email: Address: City: Province: Country: Postal Code: Home Phone: School Awards: I would like to be in the Sport Academy because: Number of Years Playing Hockey: Level of Hockey I Current Play: House A1 A2 A3 I understand fees for the Academy are $1325.00 per year, payable in monthly installments of $132.50: No Yes