Pembroke Lumber Kings - Hockey School

Hockey School Application Form

Did you attend the Pembroke Lumber Kings Hockey School last year?:
I would like to register for:
Name:
Position:
Date of Birth:		(MM/DD/YYYY)
Height:
Weight:
Gender:
Address:
City:
Prov / State:
Postal Code / ZipCode:
Home Phone:
Work Phone:
Parent:
Email Address:
Last Years Team:
Last Years Level Played:
Years of Hockey Experience:
Jersey Size:
Health Card #:
Medical History:
Please make all cheques payable to Pembroke Lumber Kings, write your child's name & "Hockey School" on the cheque and send to: Pembroke Lumber Kings P.O. Box 92 Pembroke, Ontario CANADA K8A 6X1 Applications are accepted first come-first serve by order of payment received.
By submitting I am agreeing to terms above.