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Registration Form

Download and complete the following form and send with your payment.

 Registration Form Acrobat logo

Note: Space in the programs are limited and are allocated based on receipt of payment.

To obtain more information, or to have someone contact you please fill in the form below.

Please enter your contact information below.

* Fields preceded by an asterisk are mandatory.

Goalie's name:

* Parent name:

Address:

City:

Prov./State:

Postal Code/Zip:

Country:

Home Phone:

Work Phone:

Cell Phone:

Pager:

* Email:

Current Team:

Age Group:

Level:

 

I would like a brochure mailed to me

 

I would like someone to contact me

Prefered method of contact

Home phone:

Work phone:

Cell phone:

Pager:

Email:

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"The #1 Goalie School in the GTHL"

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