Application

Application Form

First Name *

Last Name *

Middle Name

Birthdate *

Phone Number *

Email Address *

Street Address or PO Box Number *

City/Town *

Postal Code *

Province *

Name of Parent/Guardian *

Relationship to Student *

Preferred Phone Number *

Current School *

Current Grade Level *

If you are affiliated with one of the following organizations, please select it below *

If other, please state your associated Sporting Organization/Club here

Name of Sport Played *

Coach Name and Contact *

Level (AA, AAA, Tier 1, Advanced, Elite) *

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