You may use this form to inquire about the development of a unique personal coaching or group coaching plan, or to reserve a spot in an existing program. All program reservations will require submission of the waiver via the checkbox, and will require the subsequent payment of a deposit to guarantee your reservation in the program. Early reservations will be given priority. If the athlete is under the age of 18, you will need to submit all parental information and we will require a return email from the parent(s) to acknowledge the waiver.

* indicates a required field
For Individual Athletes - About Me:

Male Female


City / State / Zip:


For Groups or Teams

City / State / Zip:


Individual Coaching
Other - Please specify below

(Hockey) Summer Camp
(Hockey) In Season Training
Elite Program - Individual
Group Program
Team Program

If you selected "Group Program" above, please supply details below and we will contact you with a group price structure.

Additional Comments/Details:  

By checking this box I acknowledge that I am 18 years or older and have read and agreed to the waiver outlined on this form.

By checking this box, I confirm that I am under the age of 18 and that my parent named below will read and acknowledge agreement to the waiver on my behalf in order for my reservation to be complete. My parent(s) or legal guardian can be reached at the following:

Parent / Gaurdian Contact Information

City / State / Zip:

Use this address for billing

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