Add On-Ice Volunteer (Burlington City Rep Hockey Club)

Add On-Ice Volunteer

This form is used to identify on-ice volunteers for your team.

Your Name^*

Required

Name of person submitting the form - usually Manager

Email Address^*

Required

Confirmation of this form will be emailed here

Team Name^*

Required

First Name^*

Required

Person being added

Last Name^*

Required

Person being added

Position^*

Required

Date of Birth^*

Required

Required to access Hockey Canada profile

Address^*

Required

Full Address including Postal Code

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 (Parent Rep Only)?^*

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