2019/2020 Fall Session Goalie Development Registration Form (LaSalle Minor Hockey Association)

Print 2019/2020 Fall Session Goalie Development Registration Form
This form has a limit of 15 submissions. At the moment this page loaded, 10 submissions have been submitted. It is possible that not all submissions have been validated at this time, and more openings could become available. However, at this time only 5 more submissions will be accepted.
General Information
Use this form to register and pay for the goalie clinic that is being offered by LMHA. For drop in rate and availability, please contact Derrick Laporte at [email protected] Dates: Sept 13, 20 , 27 Oct 4, 11, 18, 25 Nov 1, 15, 22, 29 Dec 13, 20, 27
    Email Confirmation
    You will receive a confirmation email after your submit the form. The confirmation will show you the information that you submitted. If you do not receive a confirmation email, please contact [email protected]
      PeeWee Major and Higher Shooters Needed
      10 PeeWee Major and older shooters are needed. Players must wear all required hockey gear on the ice. Please contact Derrick Laporte at [email protected] NOTE: Any helpers 14 and under must wear full equipment when on the ice.
        Player Information
        Please complete the below required section with your player's information.
        Parent Information
        Please include parent contact information
        1. Example: ###-###-####
        2. Example: [email protected] Your submission will be sent to this address.
        Payment Information
        Session runs for 14 weeks: Sept 13, 20 , 27 Oct 4, 11, 18, 25 Nov 1, 15, 22, 29 Dec 13, 20, 27
        1. Payment for this clinic is required in order for any player to participate.  Only those who have paid will be eligible to participate.

          Payment is required through PayPal (either with your PayPal account or with a Credit Card through PayPal).  When you submit the registration form, you will be prompted for payment.
        Human Validation
        This form has a limit of 15 submissions. At the moment this page loaded, 10 submissions have been submitted. It is possible that not all submissions have been validated at this time, and more openings could become available. However, at this time only 5 more submissions will be accepted.
        Printed from lasallesabres.com on Monday, November 18, 2019 at 7:28 AM