Don Lucia Hockey Camps

Lucia Hockey Camp Registration Page

STEP 1
Fill out registration form (don't print yet!)

STEP 2
Verify registration information (don't print yet!)

STEP 3
Open and print PDF, sign, and mail along with registration fee

Please fill out the application below, including all required fields, and click "Submit".

Adobe Acrobat Reader is required to view and print your application

First Name
Last Name
Email Address YOUR EMAIL ADDRESS WILL BE USED FOR ALL FUTURE COMMUNICATION PLEASE DOUBLE-CHECK YOUR EMAIL ADDRESS BEFORE SUBMITTING REGISTRATION
Camp
Skill Level
Position
Session Preference
Home Phone Number
Work Phone Number
Cell Phone Number
Address 1
Address 2
City
State/Province:
Zip
Birthdate (mm/dd/yyyy)
Grade
Gender
Carpool Preference
Please Group Camper With Following Camper(s)
Do you have specific health problems or injuries?	Yes No
If yes, please explain
Allergies
Emergency Contact
Emergency Contact Phone
Physician Name
Physician Phone
Insurance Company
Policy Number
Each player is responsible for his own medical insurance and the information must be included to be accepted as a candidate.