2017-18 Kirkland Lake GoldMiners Player Info

2017-18 Kirkland Lake GoldMiners Player Info
Name

First Name Last Name
Date of Birth

- Month - Day Year
E-mail

Address

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Home Number

- Area Code Phone Number
Cell Number

- Area Code Phone Number
Health Card Number
Parents Names

First Name Last Name
First Name Last Name

Parent's Address

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Parent's Number

- Area Code Phone Number
Parent's number

- Area Code Phone Number
Previous Coach's Name

First Name Last Name
Previous Coach's Number

- Area Code Phone Number
Previous Team, Category & League
Position (s)
Shot
Height
Weight
Known Drug Allergies
Ever been diagnosed with a concussion
Concussion date
Fracture, Groin or Shoulder injuries
Injury details
Ever had surgery
Surgery details
Current medication(s)
Glasses/contacts required for hockey
Attending school
What grade/College program
Average/grade received in most recent school yr.
Valid Passport
Twitter Handle
Facebook Page
Instagram
Should be Empty:

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