ICE HOCKEY ENROLMENT TERM 1-2011

LEARN THE BASICS OF ICE HOCKEY

Name...................................................................Age..............

Address....................................................................................

Parent/Guardian........................................................................

Contact Phone..............................Email.....................................

Thursdays 5pm To 6pm 17th Feb - 14th April (Children 5+years) 

How did you learn about Kiwi-Hockey?

Friend               [   ]

School              [   ]

Newspaper        [   ]

Website            [   ]

Other               [   ]

Signed ..................................................Parent/Guardian

Please return with your $72 payment to the Dunedin Ice Stadium

(a full set of gear can be provided with a bond of $50)