Add Bench Staff (Burlington City Rep Hockey Club)

Add Bench Staff

Bench Staff includes Coaches, Trainers and Managers.

Team Name^*

Required

First Name^*

Required

Person being added to the Team Roster

Last Name^*

Required

Person being added to the Team Roster

Position^*

Required

This question is only to be answered if the Position you chose was Manager. Is the Manager going on the Bench during games?

Rostered Position (Allowed on the Bench)
Non-Rostered Position (Not allowed on the Bench)

Please disregard this question unless you chose MANAGER in the previous question.

Date of Birth^*

Required

Required to access Hockey Canada profile

Address^*

Required

Full Address including Postal Code

Do you have a child playing on this team?^*

ParentNon-Parent

Required

This contact info will be used by the Eagles Office Staff and Administration.

Email Address^*

Required

Phone Number^*

Required

Example: ###-###-####

Is this the Contact Info you would also like visible on the Eagles Website?^*

YESNO

Required

If NO, please complete Eagles Website Contact information below

Eagles Website Email Address

Not required if same as above

Eagles Website Phone Number

Not required if same as above

Any additional information or instructions