BERTI HOCKEY REGISTRATION FORM

BERTI HOCKEY REGISTRATION FORM

(Please note this form may not display correctly on mobile)
Player Name*

First NameLast Name
Birth Date*

MonthDayYear
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Position (full equipment is required)*

SkaterGoalie (Free)
Minor Hockey Experience*

1-2 years2+ years
Which camp are you registering for?*

U11 August Tryout Prep Camp ($90/skater for 3 sessions)U13 August Tryout Prep Camp ($120/skater for 4 sessions)
Payment method (payment required before first session)

e-Transfer (to bertihockey@gmail.com)Cheque (payable to Bastien Berti)Cash
Parent/Guardian Name*

First NameLast Name
Phone Number*

Area CodePhone Number
E-mail*
Questions or comments
Thank you for registering, I will reach out via email with confirmation. Refunds available until July 31st, 2022.
Should be Empty: