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Sparkle's Hockey Academy for Ladies and
Gents |
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Sign Up Form |
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| *First
Name: |
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*Surname: |
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| *Email: |
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*Phone Number: |
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| *Date
of Birth: |
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Gender: |
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M |
F |
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| *Name
of Course: |
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| Please
add me to the Sparkle's Hockey Academy update email list. |
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Y |
N |
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| Would
you be interested in purchasing Sparkles Hockey Academy Gear? |
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Y |
N |
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If Yes, then which, if any would
interest you? |
Practice Sweater |
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T-Shirt |
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Moisture Control T |
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Hooded Sweatshirt |
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medical Issues we should be aware of? |
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| *Emergency
Contact Name: |
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| *Emergency
Contact Number: |
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| How
did you hear about Sparkle's Hockey Academy? |
Web |
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Friend |
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GTHLA |
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Hockey Toronto |
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Former Student |
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Other |
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2 quick questions (Choose the closest
reponse). |
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| I
would estimate my skating ability as: |
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My general Hockey
Knowledge consists of: |
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I watched Elvis Stoiko on TV once. |
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A. I watched Elvis Stoiko
on TV once |
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I've been out once or twice and can stand up |
B. You put the.. Puck, in
the.. Net. |
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| C.
I can skate forwards, backwards and Stop. |
C. Offsides - Check.
Icing - Check. Put me in coach. |
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| D.
I could beat Rocket Richard in a foot race. |
D. I can explain the Left
Wing Lock. |
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| Comments: |
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| *Signature |
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Date: |
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| Please
note: Both this form and the waiver are required to enroll |
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*Required Fields |
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