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2010 Player Recruitment Form- on June 5 & 6@ Leam. Kinsmen Rec. Complex

March 8, 2010

Please fill in the following form fields. The price is $75.00 and your registration will be confirmed after a cheque is received.

PLEASE SEND CHEQUE TO 75 ALDERTON ST LEAMINGTON,ONTARO

N8H 4L9
Name
Address
Town / City
Postal / Zip Code
Phone (with Area Code)
Fax
Email
Date Of Birth (dd/mm/yyyy)
Position
Shoot (L/R)
Height
Weight
2009/10 Team
Coach
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