*REGISTRATION – Xcelerate Hockey

Player Registration

fields marked with an asterisk (*) are required.

Name*

First

Last

Address*

Street Address City Province Postal

Date of Birth*

day

/

month

/

year

Gender:*

Female

Male

Email*

Home Phone:*

Area Code

–

Phone Number

Cell Phone:*

Area Code

–

Phone Number

Business Phone:

Area Code

–

Phone Number

2018-2019 Team Association*

Select Player Position*

Select Program Requested:*

Select Week Requested:*

Medical Information:*

Parent Name*

First

Last

NEWS & UPDATES

Read all about it…

Belmont Minor Hockey Skills & Drills

PROGRAMS

$160

$410*

$250**

2019 Summer Program Features:

Full Day Programs
First Class Facilities
15 Hours of Ice Time per Week
Low Student-Instructor Ratio
Professional, College & Junior Hockey Instructors

2019 Xcelerate Hockey Jersey
Daily Snacks
Pizza Lunch on Friday

P.O.Box 502
Belmont, ON
N0L 1B0

519-644-1846

e: xcelerate@sympatico.ca

NEWS & UPDATES

Read all about it…

PROGRAMS

$160

$410*

$410*

$250**

2019 Summer Program Features:

xcelerate hockey © All Rights Reserved. Jason clark