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Date:
*
June 27 2010
July 4 2010
July 11 2010
July 18 2010
Participant's Name:
*
Mailing Address:
*
City:
*
Province/State:
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Postal/Zip Code:
*
Age:
*
Date of Birth:
*
Parent Name(s):
*
Home Phone:
*
Alternate Phone:
*
Contact Email:
*
Health Care #:
*
Health Problems:
The level the participant was in this year:
*
Expected hockey level after the school: