Clinic InfoWhat clinic or camp are you registering for?*Select a Clinic/CampDefence ClinicsDefencemen Specific Half Day Hockey CampFull Day Total Hockey CampGoal Scorers Advanced Half Day Camp 2019Goal Scoring, Shooting & Skating Skill Work SessionsJuly Defence CampJuly Goal Scorers CampSeptember Mini SkatesThursday Night Shooting ClinicsThursday Night Shooting ClinicsTotal Hockey Skills and Power Skating Skill Pre-Tryout Development Camp (2003-2007)Total Hockey Skills and Power Skating Skill Pre-Tryout Development Camp (2008-2011)Clinic Start Date* MM slash DD slash YYYY Player InfoPlayer's Name* First Last Player's Birthdate* MM slash DD slash YYYY Level* Contact InfoHome Phone Number*Alternate Phone NumberEmail* Address* Street Address Address Line 2 City AlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon Province Postal Code Parent 1* First Last Confirming HumanRelease of Liability and Acknowledgement of Risk*It is agreed that Dave Cullen and any other instructors are released from any and all claims from damage that may arise from an accident or injury which was caused by or arose from participation of the applicant hereon during the program in any location where the program is held. I agreeNameThis field is for validation purposes and should be left unchanged.