Registration Form

Heartland Hockey Camp Application 2010

Step 1 Fill Out The Following Info.

Email:
Campers Name:
Address:
City:    State:    Zip:
Phone (Day)
Phone (Night)
Birthdate: Age:
Height: Weight:
Position: Jersey Size:
Roommate Requested
Medical Insurance Co.
Medical Insurance No.
How Did You Hear About Heartland Hockey Camps?


Step 2 Please Check appropriate box below to select your camp.

 

(Mite age approx 5-8 years)

   (Boarding Fee/Day Fee)

Mite Camp June 20-26

  
$975.00 / $825.00

Mite AAA Camp June 27 - July 3

  
Boarding $1075.00

Mite Camp July 18-24

  
Boarding $975.00

Mite Select Camp Aug 1-7

  
Boarding $1025.00


 
(Squirt age approx 8-10 years)
   (Boarding Fee/Day Fee)

Squirt June 20-26

  
$975.00 / $825.00

Squirt AAA Camp June 27-July 3

  
Boarding $1075.00

Squirt Camp July 18 - July 24

  
Boarding $975.00

Squirt Select Camp July 25-31

  
Boarding $1025.00

Squirt Super Select Camp Aug. 1-7

  
Boarding $1050.00


 
(PeeWee age approx 10-12 years)
   (Boarding Fee/Day Fee)

PeeWee Camp June20 - 26

  
$975.00 / $825.00

PeeWee Select Hockey Camp June 27 - July 3

  
$1025.00 / $850.00

PeeWee AAA Camp July 4 - July 10

  
Boarding $1075.00

PeeWee Camp July 18 - July 24

 
Boarding $975.00

PeeWee Select Camp July 25 - July 31

 
Boarding $1025.00

PeeWee Select Camp August 8 - August 14

  
Boarding $1025.00

PeeWee Super Select Camp August 8 - August 14

 
Boarding $1050.00


 
Bantam Hockey Camps
(approximate age 12-14) years)
   (Boarding Fee/Day Fee)

Bantam AAA Camp July 4 - July 10

  
$1075.00

Bantam Select Hockey Camp July 11 - July 17

 
Boarding $1025.00

Bantam AAA Camp July 11 - July 17

 
Boarding $1075.00

Bantam Super Select Camp July 25 - July 31

  
Boarding $1050.00

Bantam Select Camp August 1 - 7

 
Boarding $1025.00

Bantam Select Camp August 8 - 14

 
Boarding $1025.00


 

High School Hockey Camps
Approximate age 15-18

   (Boarding Fee)

High School Select Camp July 11 - 17

  
Boarding $1050.00

High School Super Select July 18 - July 24

  
Boarding $1075.00


 
Goalie Camp
   (Boarding Fee/Day Fee)

Goalie Camp July 4 - July 10

  
Boarding $975.00


 
Girls Hockey Camp
(No age restriction)
   (Boarding Fee/Day Fee)

Girls Hockey Camp June 20- June 26

 
$975.00 / $825.00

Girls Hockey Camp June 27 - July 3

  
$975.00 / $825.00


Mom or Dad (Optional) Full Service Fee $850.00
Mom or Dad (Optional) Lodging, Meals & No Ice Fee $750.00
Mom or Dad (Optional) No Boarding, Ice & Meals Only Fee $650.00

Please note: All camps are available for mom or dad to attend, this is an optional feature,
it is not mandatory that mom or dad attend with their campers.



 

Adult Camp

   (Boarding Fee/Day Fee)

Adult Camp August 15 - 21

  
Day Fee $1,100.00


 

Step 3 Fill Out Parental Consent Form.

In consideration of the acceptance of (Campers Name) as a student in Heartland Hockey Camps, the applicant agrees that Heartland Hockey Camps and / or their staff, coaches or employees will not be held responsible for any accidents or loss of personal property, however caused, and agree to release the Camp from all claims or damages which may arise as a result of such accidents or loss. It is further agreed that all risks attendant to watching and / or participating in the Heartland Hockey Camps are assumed by the student and his / her parents and / or guardian and this assumption is acknowledged, approved by the signature hereto.

We have read the foregoing, and have explained its meaning to our son / daughter, and agree to the terms and conditions stated. We the parents of the above signed applicant, give our consent to his / her participation in Heartland Hockey Camps.

 

 
___________________________________________________________________
Signature of Parent                                                            Date

 

Step 4 Print this form, Sign the Parental Consent Portion

Applications must be accompanied by a 50% deposit, in the form of a personal check, money order, or cashiers Check. We request that you send a postdated check with your application and deposit to ensure that it is not overlooked. The balance is due before June 1st. Payment in advance is also acceptable.

There will be a $25.00 late fee assessed after June 1, 2010

Mail this application and deposit to:
Heartland Hockey Camps
24921 Arena Dr.
Deerwood Minnesota 56444

Step 5 Press the Send to Heartland Button below, this will hold your reservation in the appropriate camp until your deposit arrives.

(If your deposit does not arrive within 10 days, we will assume you are no longer interested, and cancel your reservation!!)

 

 

Use Your BACK Button to Return

Heartland Hockey Camps

24921 Arena Dr.
Deerwood, MN 56444
(218) 534-3298 Out of State Boardings (825) 945-7465
Fax (218) 534-3297
E-Mail: Steve@heartlandhockey.com