ISLAND HOCKEY EXPERIENCE
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Application

To Reserve a spot in the clinic please Register Today!

1.  To register either submit the online application below or email us for a PDF application: islandhockeyexperience@gmail.com

2. Please send your check or money order for the $200 non-refundable deposit or full payment and your registration form to:

Sean Kotary
Clinic Director
Island Hockey Experience
6107 Harbor Drive
Washington Township, MI 48094

islandhockeyexperience@gmail.com
ONLINE APPLICATION

By registering electronically, I certify that my child will be USA Hockey Registered during the week of July 31 - August 4, 2017.  Island Hockey Experience, its directors, coaches, agents, and Nantucket Ice Co. are hereby held save harmless from any and all liability for injury or illness while participating in the activities of this clinic. 

 

Registration is not considered complete until a $200 non-refundable deposit is received by check or money order. 

Player Name:     
Parent or Guardian:
Address Street 1:
Address Street 2:
City:
Zip Code: (5 digits)
State:
Contact Email:
Contact Phone:      
Player DOB:
Position:
2016-17 Team and Level:
Youth Hockey Level Next Season (2016-17):
Jersey Size (Youth/Adult; S-M-L-XL)
USA Hockey Registered
Registered
Comments:




www.IslandHockeyExperience.com


Contact Information

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First Name:
Last Name:
Address Street 1:
Address Street 2:
City:
Zip Code: (5 digits)
State:
Daytime Phone:
Evening Phone:
Email:
Comments:

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