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Lifetime Hockey
Skills and Drills Registration
Athlete Information
an asterix (*) marks required fields.
Last Name
*
First Name
*
Date of Birth
*
Alberta Health Care
*
Enter the athlete's nine-digit Alberta Health Care Number.
Street Address
*
City/Town
*
Postal Code
*
Home Phone
*
Please enter the full 10-digit phone number XXX-XXX-XXXX
Email Address
*
Program Information
Select Skills Camps
Offensive Skills
Defenceman Clinic
Checking
*
Contact Information
Primary Parent/Guardian
*
Parent or Guardian's full name
Primary Parent Cell Phone
Please enter the full 10-digit phone number XXX-XXX-XXXX
Other Parent/Guardian
Parent or Guardian's full name
Other Parent Cell Phone
Please enter the full 10-digit phone number XXX-XXX-XXXX
Additional Information
Hockey Association
The current association or team the athlete plays for.
Level Played
Allergies
Any relevant allergies the athlete may have.
Medical Conditions
Any medical conditions pertaining to the athlete.
Comments
Any additional comments you may have.
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