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East Coast Field Hockey ON-LINE Application form 2010

Fill out completely the form and submit when completed
The application form 20 will be sent automatically to East Coast Field Hockey.

Complete all Personal information

Name:
Age:
Address:
City:
State :
 Zip
Phone:
DOB:
Email:
High School Name :
Insurance Policy:
 
Position:
Goalie  Field Player
Experience:
 Beginner Varsity
Futures Program:
 Yes no  
T-Shirt Size:
 S M L XL
Recruiting Video:
 Yes no  $225.00
ALL INFORMATION IS REQUIRED FOR SUCCESSFUL REGISTRATION
Make your check payable to:
East Coast Field hockey
Send to:
P.O. Box 172, Hershey, PA 17033
 

Fees
Indoor Hockey Camp, Hershey PA Jan 1 - 3 $125.00
Mendoza High Performance Course, Rosemont, PA Jul 4 - 16 $950.00
National GK 1 Academy, , Rosemont, PA (6 days) Jul 11-16 $515.00
Junior Ademy, , Rosemont, PA Jul 18-22 $375.00
National Academy, , Rosemont, PA July 18-22 $475.00
Conditioning Camp for Field Players, , Rosemont, PA July 18-22 $475.00
National Elite Academy (6 days), , Rosemont, PA July 11-16 $515.00
National GK Academy 2 (5 days), Rosemont, PA July 18-22 $485.00
National Striker Camp (6 days), Rosemont, PA July 11 -16 $475.00
High School Team Camp 1, Rosemont, PA Jul 18-22 $475.00
High School Team Camp WEST, Slippery Rock Univ. Jul 25 - 29 $475.00
College Player Camp, Slippery Rock Univ. July 25 -29 $475.00
California Team Camp 1, San Diego July 25 -29 $475.00
California Team Camp 2, San Diego Aug 1 - 5 $475.00
High School Team Camp 2, Estella, PA Aug 1 - 5 $475.00
High School Team Camp 3, Estella, PA Aug 8 - 12 $475.00
High School Team Camp 4, Estella, PA Aug 15 - 19 $475.00




$175 Deposit required. All payments non refundable.
All training camp payments MUST be received prior to 1st of June 2010
No Cancellation accepted after 1st of May 2010

Total   Date

The undersigned, a parent or legal guardian of this player, understands and accepts that the risk of injury is possible while playing the sport of field hockey. I authorize the directors to act for me according to their best judgement in any emergency requiring medical attention. I authorize medical treatment as requiered


Signature of Parent or Guardian
Congratulations on "Accepting the challenge"
The application form 2010 will be sent automatically to East Coast Field Hockey.

After submittal, print a copy of the completed application and mail immediately with your deposit to finalize the application process. Checks, money orders and cash are accepted for payment. Credit card payment options will begin 1 January 2010 however a 2.5% processing fee will be charged to your credit card for on line payments.