Please print out a copy of this form, complete, and mail to:
ALCAN
Hockey, PO
Box
80691, Fairbanks, AK, 99708
Or Drop off at Play It Again Sports or Sport King in Fairbanks.
If you have any questions please contact:
Alaskan Canadian Hockey Schools: phone (907) 455-4203
NAME: _________________________________________ AGE: ____________________
ADDRESS: _______________________________________________________________
CITY: _________________________________ STATE/PROV.: _____________________
ZIP/POSTAL CODE: _________________________
PHONE: _________________________ DAY TIME PHONE: _______________________
EMAIL: ____________________________________________________________________
LAST TEAM/AGE DIVISION: __________________________________________________
YEARS OF EXPEREINCE: _____________________________________________________
HEIGHT: ________________________ WEIGHT: __________________________________
MEDICAL INFORMATION: (Allergies or any special conditions):__________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
I WISH TO ATTEND & ENCLOSED IS A CHECK FOR THE FOLLOWING CAMP:
Full Program: ($500): _____
*Deposit: ($150) ______
* Deposit is non-refundable to reserve placement in program
ALASKAN-CANADIAN HOCKEY SCHOOLS INSURANCE WAIVER
NAME OF PLAYER: ________________________________ DATE: __________________