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TRAINING CAMP '06

CAMP OPENS SEPTEMBER 8, 2006

COST $75/PERSON

Personal Information -

Name:

Birthdate:

Address:

City:

Province:

Postal Code:

Home Phone:

Email:

Fathers Name:

Mothers Name:

Work Phone:

Cell Phone:

Athletic Information -

Position:

Height:

' "

Shoots:

Weight:

Lbs.

Team 2005/2006:

Stats 2005/2006:

Skaters:	GP		Goals		Assists		Points		PIM
Goalies	GP		GAA		Save %		Wins		Losses

Personal Goals:

US College

JR.A

WHL

Other

CHEQUES CAN BE MAILED TO -
ROB REIMER
P.V. HAWKS
3 MAPLE LEAF CRES
MORDEN, MB
R6M 1R2
PLEASE INCLUDE YOUR PROVINCIAL HEALTH # AT THAT TIME

IF YOU DO NOT RECEIVE CONFIRMATION OF RECEIPT
WITHIN 3 DAYS OF SUBMITTING THIS FORM PLEASE
CONTACT rlreimer@mts.net