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    This document is a registration form for Anthony Micucci's School of Goaltending. It requests the student's name, contact information, age, gender, playing level, which clinic or camp they want to attend, and any comments or questions. It also provides the school's address and requires a $100 deposit check made payable to Anthony Micucci's School of Goaltending, with no refunds given.

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    mail-in form

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    This document is a registration form for Anthony Micucci's School of Goaltending. It requests the student's name, contact information, age, gender, playing level, which clinic or camp they want to attend, and any comments or questions. It also provides the school's address and requires a $100 deposit check made payable to Anthony Micucci's School of Goaltending, with no refunds given.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    507 views1 page

    Mail-In Form

    Uploaded by

    api-99355324
    This document is a registration form for Anthony Micucci's School of Goaltending. It requests the student's name, contact information, age, gender, playing level, which clinic or camp they want to attend, and any comments or questions. It also provides the school's address and requires a $100 deposit check made payable to Anthony Micucci's School of Goaltending, with no refunds given.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
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    Anthony Micuccis

    School of Goaltending
    Mail in this form along with a
    Deposit Check of $100.00
    (remainder due at time of registration)
    Send it to:
    Anthony Micuccis School of Goaltending
    3024 Kirschner Parkway
    Hamburg, New York 14075
    Students Full Name: ______________________________________________
    Parent(s) Name(s): ______________________________________________
    Address 1: ______________________________________________________
    Address 2: ______________________________________________________
    City: ______________________ State: __________ Zip Code: ___________
    Telephone: ________________ E-mail Address: _______________________
    Age: ____ Male: ____ Female: ___ Current Playing Level: ______________
    Clinic/Camp would like to Attend: _____________________________________
    Comments or Questions: ___________________________________________
    ________________________________________________________________
    Please make check payable to:
    ANTHONY MICUCCIS SCHOOL OF GOALTENDING
    (NO REFUNDS given under any circumstances)

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