Anthony Micucci's
School of Goaltending
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Click here for a printable "Mail-in" Registration Form
(Adobe PDF format)
Opens in a separate window, close newly opened window when finished.
(Need ADOBE Reader? download a FREE copy here)
or use the EZ E-mail online registration form below
Online Registration Form
Students Full Name:
Parent(s) Name(s):
Address 1:
Address 2:
Type
"NONE"
in the box above if this does not apply
City or Town:
State:
Zip Code:
Telephone:
E-mail address:
Age:
Male or Female:
Current Playing Level:
--- PLEASE CHOOSE YOUR LEVEL ---
Women's
Novice
House
Mite
Squirt
Pee Wee
Bantam
Midget
Junior
Prep School
College
Other not listed
Camp/Clinic you would like to attend:
refer to the Camps page for dates/times
--- CAMP/CLINIC TO CHOOSE FROM ---
Week Camp No. 1 (COMPLETED) (Holiday)
Week Camp No. 2 (COMPLETED) (Lesiure)
7 Week Program (COMPLETED) (Pepsi)
AM Deal A (COMPLETED)
AM Deal B (COMPLETED)
Private Training
Youth Program
Method of payment:
I will contact you for further information
--- METHOD OF PAYMENT---
Personal Check
Cash
Other
Questions or Additional Comments:
Use your browser
"Back"
button to return to this page
after submitting form successfully
Other forms required at 1st day of camp
Each form opens in a separate window, close newly opened window when finished.
Note:
If you have signed up for any of the camps this year, please print out this form,
fill in the information and then bring it with you to the first day of camp.
Click here for a printable "Insurance Waiver" Form
(Adobe PDF format)
Click here for a printable "Medical Information" Form
(Adobe PDF format)
(Need ADOBE Reader? download a FREE copy here)
Home
|
About Us
|
Placements
|
Camps
|
Photo Gallery
|
What's New
|
Registration
|
Merchandise
|
News Articles
|
Links
|
Testimonials