Premier Field Hockey Academy
Registration
2017-18

 
PARTICIPANT INFORMATION
Last Name * indicates required field
First Name *
Male/Female *
Current Grade *
Birthdate * Month/dd/yyyy) (ie: May/19/2002
PRIMARY PARENT CONTACT INFORMATION
Primary Parent Contact Name *
Primary Contact Telephone *
Primary Contact Email *
Primary Contact Home Phone
Primary Contact Work Phone
Primary Contact Cell Phone
Address *
City *
Postal Code *
OTHER PARENT CONTACT INFORMATION
Other Parent Contact Name
Other Parent Contact Telephone
Other Parent Contact Email
Other Parent Contact Home Phone
Other Parent Contact Work Phone
Other Parent Contact Cell Phone
Address (If different from above)
City
Postal Code
ADDITIONAL INFORMATION
Student's Current School *
School Location * (ie: West Vancouver, North Vancouver, etc.)
School Attending this September *
Current Field Hockey Level * (Beginner, Intermediate, Advanced)
Current Position *
Last Team (played on) *
Coach *
Coach Phone *
Coach Email *
Favourite Jersey Number
Please submit the following information via .pdf .doc or. rtf.
(use the "Browse" button to attach the file from your computer
)

1. Athletic Goals: Tell us not only your athletic goals, but let us know what you hope to accomplish by participating in the Premier Field Hockey Academy.
2. Athletic Achievements over the past three years. Tell us about some of your experiences both in the area of field hockey and in any other area of passion or interest.
3. A statement indicating why you would be a good candidate for the Premier Field Hockey Academy.
4. Please scan a copy of the student's most recent report card to dnelson@wvschools.ca.

* Attach document here:

Please click "Submit Registration" button only ONCE and wait...