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2023 Tec-Tac Application
Please fill out this form, click on the DOWNLOAD AND PRINT COMPLETED FORM green button below, then mail it with full payment to the address on the form. You may also Print a blank form, fill it out by hand, then mail it with full payment to the address on the form.
Student First Name:	Male:   Female:
Student Last Name:	DOB: Month JanFebMarApr MayJuneJulyAug SeptOctNovDec Date12345678910111213141516171819202122232425262728293031 Year19451946194719481949195019511952195319541955195619571958195919601961196219631964196519661967196819691970197119721973197419751976197719781979198019811982198319841985198619871988198919901991199219931994199519961997199819992000200120022003200420052006200720082009201020112012201320142015201620172018
Street Address:
City:
Province or State:	select AlbertaBritish ColumbiaManitoba New BrunswickNewfoundland and Labrador Northwest TerritoriesNova ScotiaNunavut OntarioPrince Edward IslandQuebec SaskatchewanYukon -------------------- AlabamaAlaskaArizonaArkansas CaliforniaColoradoConnecticutDistrict of Columbia DelewareFloridaGeorgiaHawaii IdahoIllinoisIndianaIowa KansasKentuckyLouisianaMaine MarylandMassachusettsMichiganMinnesota MississippiMosouriMontanaNebraska NevadaNew HampshireNew JerseyNew Mexico New YorkN. CarolinaN. DakotaOhio OklahomaOregonPennsylvaniaRhode Island S. CarolinaS. DakotaTennesseeTexas UtahVermontVirginiaWashington West VirginiaWisconsinWyoming
Postal/ZIP Code:	Country:  CanadaUnited States
Parents' Names:
Telephone:	- - Home - - Work
Parent E-mail:
Confirm E-mail:
Student Health Number:
Student Jersey Size:	Small Medium Large Extra-Large
Student Hockey Position:	Goalie
REGISTERING FOR:	NOVICE SKILL DEVELOPMENT (Week 2) Ages 6-8 Aug. 21 to Aug. 25, 2023  OPENINGS FOR 3 GOALIES ONLY
"To Raise The Athlete From Excellent Hockey To Hockey Excellence!"