STEP 1: Complete this form.
 
Basic Information
Participant Name:  
Parent Name:  
Address:  
City:      Zip / Postal Code:  
E-Mail:  
Primary Telephone: ( ) -  
Fax (Optional): ( ) -  
Cell (Optional): ( ) -  
 
Personal Data
Date of Birth:  
Height and Weight: Feet, Inches                Pounds  
Sex:
 
Medical Information: (optional, confidential)  
 
Level of Play Last Year
(Check all that apply)
AAA      AA       A      House League      Mite      Squirt      Pee-Wee      Bantam      Other
 
Position and Hockey Jersey Size
(we take extra jerseys to each location)
Forward / Defense           Goaltender
 
Other Information and Details
Have you attended Maximum Development Hockey School before?
If so, when?
How did you hear about Maximum Development Hockey School?
Brochure       Poster       Internet       Hockey Weekly       Word of Mouth      Other:
 
Session Preferred in 2011
(Please check one)
# Date Location Arena Times Fee ($USD)
1 August 1-5 Ann Arbor, MI Ann Arbor Ice Cube 9am - 3pm

$399
$199
2 August 8-12 Baldwinsville, NY Greater Baldwinsville Ice Arena 9am - 3pm

$249
$149
Note: Fees vary by location according to Ice Costs
 

Note: FEES VARY BY LOCATION ACCORDING TO ICE COSTS

Please include check or money order (in U.S.$) and make payable to:

MD Hockey
P.O. Box 261
Station A
Windsor, ON
N9A 6K7
CANADA

or
FAX to: (519) 966-3446

Any Questions? Call 1-888-54-MD-ICE (546-3423)
(Toll-Free from anywhere in U.S. or Canada)
 

Registration FEES

See above schedule.

(50% due with this form, 50% due on or before 1st day of Session)

DISCOUNTS!!!

Take $20 OFF for every applicable discount!

Registered before April 30
Attended Previously
Additional Family Member

STEP 2: Print this completed form using the button directly below.
 
STEP 3: Complete the field below to validate the form, and then click 'Submit' to send this registration form electronically.
Submitting this form only reserves your spot for 7 days, you must mail in a printed form along
with a 50% deposit within seven days to be guaranteed a spot in your selected session.