CHA Registration form

*Program

Personal information (*required)
*Player´s Name
*Team
Contact
*Date of birth (day/month/year)
Coach name
Contact
Family and Club information
*Parent name (s)

*Address/Street/City/Zip code
*Phone/Fax
*Mobile
*Email
*Security Code

Please fill out this registration form and send it to CHA Email or Fax below
Emai: miroslav.h@hockeyadventure.cz
We´ll send you more camp and payment Info