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| Player Information |
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| First Name: |
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| Last Name: |
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| Birthdate: |
Day
Month
Year
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| Address: |
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| City: |
State
/ Prov. |
| Postal / Zip Code : |
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| Email: |
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| Telephone: |
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| Position: |
All
Forward
Defense
Goalie |
| Height: |
Inches:
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| Weight: |
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| Shot: |
Left
Right |
| Please indicate the division played in 2009/2010 season: |
| Name of Association: |
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| Hockey Level: |
House
Rep Level |
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Tyke
Atom Peewee
Bantam |
| All players will be supplied Pacific Elite Hockey
School jerseys. |
| Emergency Contact & Information |
| Medical Conditions : |
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| Medical Insurance #: |
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| Parent's Name: |
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| Home Phone: |
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| Emergency Contact: |
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| Home Phone: |
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| Payment Information |
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Cash (Do not mail)
Cheque Visa
Mastercard |
| Card Holder Name: |
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| Credit Card #: |
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| Expiration Date: |
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Course Level Requested: |
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2010 August Hockey Schools |
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Rising Stars (2002-2003)..............$299.99
(August 9-14, 2010, Richmond Ice Centre) |
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Rising Stars (2004-2005)..............$299.99
(August 9-14, 2010, Richmond Ice Centre) |
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Superstars (1993-1995)..............$399.99
(August 16-21, 2010, Richmond Ice Centre) |
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Superstars (1996-1997)..............$399.99
(August 16-21, 2010, Richmond Ice Centre) |
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Superstars (1998-1999)..............$399.99
(August 16-21, 2010, Richmond Ice Centre) |
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Superstars (2000-2001)..............$399.99
(August 16-21, 2010, Richmond Ice Centre) |
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Goaltenders (1993-2001) ...........$399.99
(August 16-21, 2010, Richmond Ice Centre) |
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PEHS may alter age group categories, if necessary, to facilitate registration requirements. The proper grouping will be done keeping in mind the skill requirements of the participants. At all times high coach/player ratios will be maintained. |
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Elite Power Performance Package |
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Elite Power Performance Package (1995-1996-1997)...$179.99 + gst
(August 30 - September 03, 2010, Trout Lake Rink, Vancouver) |
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Elite Power Performance Package (1998-1999)..............$179.99 + gst
(August 30 - September 03, 2010, Trout Lake Rink, Vancouver) |
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Elite Power Performance Package (2000-2001)..............$179.99 + gst
(August 30 - September 03, 2010, Trout Lake Rink, Vancouver) |
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Elite Power Performance Package (2002-2003)..............$179.99 + gst
(August 30 - September 03, 2010, Trout Lake Rink, Vancouver) |
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New Spring Hockey Program (2010) |
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Spring Hockey Program (2004-2005)...$249.99 + gst
(March 17 to April 1, 2010, 9 sessions) |
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Spring Hockey Program (2002-2003)...$249.99 + gst
(March 18 to April 1, 2010, 9 sessions) |
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Spring Hockey Program (1995-1996-1997)...$499.99 + gst
(April 6 to June 8, 2010, 10 sessions) |
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*IMPORTANT NOTE: The Spring Hockey Program (1995-1997) requires 3 equal payments (1st payment with registration, 2nd payment May 1 and 3rd payment June 1. |
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Should the time of a session interfere with a tryout time a refund will be given for the day missed. |
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An administration charge of $35.00 will be charged for NSF cheques and a credit only for future use at a Pacific Elite School for cancellations after July 4th, 2010 and up to the commencement of the School (August Hockey School Only). No refunds or credits will be given for cancellations after commencement of the Hockey Schools unless caused by tryout conflict. |
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All programs require a minimum 50% Deposit. It 'must' accompany
the application by Visa, MasterCard or Cheque. Select a deposit amount below: |
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50% Deposit
(balance July 4, 2010) |
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Pay in Full |
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| Security Code: |
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MAIL TO: Pacific Elite Hockey School
5812-122nd St, Surrey, B.C V3X 3L5 |
| IMPORTANT!! Please read our
disclaimer (opens in new window) before clicking submit! Thank you. |
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