Hockey Fantasy Camp




Personal Information * required fields
*Full Name: Company: *Age
Hockey Position: Height: Weight:
Address: City: Province/State:
Postal Code : Country: *Home Phone:
Cell Phone: Work Phone: *Email Address:
 
Emergency Information
*Name: Address: *Home Phone :
Work Phone: Cell Phone: *Email Address:
Health Insurance Number:
 
Equipment
*Hockey Pants: *Golf Shirt: *Underwear:
*Sticks: *Hockey Sweater: *Skill Level:
*What name and number would you like on your sweater?
 
Questions & Comments
 
Other Information

After March30th 2008 the cost of this unique opportunity is $4995.00 (CDN) plus 5% GST and includes lake side accommodation, meals, and ice-time.

A non-refundable deposit of $2000.00 (CDN) must accompany all applications.

Single room occupancy is available for $500.00, subject to availability.

Balance of payment is due upon arrival.

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