Youth Camp - Dodge County Boys High School Hockey

YOUTH SUMMER CAMP SIGNUP

If you would like to sign up for youth camp please fill out the form below. All camp sessions will fill on a first come, first served basis. Please note, that your spot will not be secure until payment is received. Thank you.

Parent's Name(Required)

First Last

Phone(Required)

Parent's Email(Required)

Player's Name(Required)

Age(Required)

DOB(Required)

Last Team Played For(Required)

Level(Required)

Emergency Contact(Required)

Emergency Phone Number(Required)

Insurance Carrier(Required)

Policy #(Required)

Does the Player Have Any Medical Conditions / Allergies?

Yes

Please List What They Are(Required)

Signature(Required)