Moose Jaw Warriors - 6

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MOOSE JAW WARRIORS P.O. Box 74 Moose Jaw, SK S6H 4N7 P: (306) 694-5711 F: (306) 692-7833

www.mjwarriors.com

MOOSE JAW WARRIORS HOCKEY CAMP REGISTRATION Last Name:

First Name:

Address: City:

Province:

Postal Code:

Email Address:

Parent’s Names:

Evening Telephone No.:

Daytime Telephone No.:

Cell Phone:

Birth Date (M/D/Y)

Age Group (checkmark): 6 - 8

9 - 11

12 - 14

Age Conditioning Camp

If Conditioning Camp name last years Team and Level Sex: Male

Female

Position:

Weight:

Goalie

Defense

Have you played league hockey with Full Body Contact:

Height:

Forward

Yes /No

COST OF PROGRAM Kids Camp - August 11th – 15th $320.00 (GST INCLUDED) KIDS CAMP BENEFITS: - 2 ½ hours ice time each day - Receive camp jersey

- Head Instructor: Warriors AC Mark O’Leary, plus current/alumni Warriors - 1 Adult & 1 Child or Student Ticket to Warriors regular season game

Please remit payment in full with application. Payment non-refundable after July 2nd, 2014. Payment Method Cheque  Money Order  Visa/Mastercard  Debit  Credit Card #

Expiry:

Camp registration is limited in each age group and is on a first come, first serve basis.

MOOSE JAW WARRIORS – Join the Journey